Provider Demographics
NPI:1508883752
Name:MIGLIORE, CHRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:MIGLIORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:MIGLIORE
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:SUITE C1
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-4430
Mailing Address - Fax:973-926-5658
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:C-1
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-4430
Practice Address - Fax:973-926-5658
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07989100207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ91002550702OtherAMERICHOICE
NJ102895TM8Medicare PIN
NJI57812Medicare UPIN