Provider Demographics
NPI:1609813294
Name:LUNDY, CHRISTINE D (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:D
Last Name:LUNDY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3951 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-5409
Mailing Address - Country:US
Mailing Address - Phone:845-803-3311
Mailing Address - Fax:
Practice Address - Street 1:3951 DANBURY RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-5409
Practice Address - Country:US
Practice Address - Phone:845-803-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400729363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02671589Medicaid
NY02671589Medicaid
NY1042G1Medicare PIN