Provider Demographics
NPI:1578660734
Name:TIGHE, CHRISTINE (NPP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TIGHE
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 JERICHO TPKE
Mailing Address - Street 2:SUITE 122W
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4436
Mailing Address - Country:US
Mailing Address - Phone:631-754-8892
Mailing Address - Fax:
Practice Address - Street 1:6800 JERICHO TPKE
Practice Address - Street 2:SUITE 122W
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4436
Practice Address - Country:US
Practice Address - Phone:631-754-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400070-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR48671Medicare PIN
NY2E5461Medicare PIN