Provider Demographics
NPI:1609836956
Name:DZUBINSKI, CHRISTINA (PAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DZUBINSKI
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W180N8000 TOWN HALL RD
Mailing Address - Street 2:TOWN HALL HEALTH CENTER
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-4002
Mailing Address - Country:US
Mailing Address - Phone:262-255-2500
Mailing Address - Fax:262-255-2434
Practice Address - Street 1:W180N8000 TOWN HALL RD
Practice Address - Street 2:TOWN HALL HEALTH CENTER
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-4002
Practice Address - Country:US
Practice Address - Phone:262-255-2500
Practice Address - Fax:262-255-2434
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI567363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41923600Medicaid
WI1609836956Medicaid
WI41923600Medicaid