Provider Demographics
NPI:1558828749
Name:CHRISTIANO, ASHLEY MARIE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:CHRISTIANO
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 1:1349 OLD FORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2648
Mailing Address - Country:US
Mailing Address - Phone:845-750-4159
Mailing Address - Fax:
Practice Address - Street 1:68 S SERVICE RD STE 350
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2358
Practice Address - Country:US
Practice Address - Phone:516-945-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY692539163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse