Provider Demographics
NPI:1558796995
Name:USYK, CHRISTINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:USYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MCKOWN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3473
Mailing Address - Country:US
Mailing Address - Phone:518-689-0244
Mailing Address - Fax:518-689-0241
Practice Address - Street 1:10 MCKOWN RD STE 102
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3473
Practice Address - Country:US
Practice Address - Phone:518-689-0244
Practice Address - Fax:518-689-0241
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1306421Medicaid
MA2220002001OtherBLUE CROSS BLUE SHEILD
MA1308785Medicaid
MAM15684OtherBLUE CROSS BLUE SHEILD
MA2220002001OtherBLUE CROSS BLUE SHEILD