Provider Demographics
NPI:1619014420
Name:WILLIAM, CHRISTINA FAIG (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:FAIG
Last Name:WILLIAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:FAIG
Other - Last Name:WILLIAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:156 WEST AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-1229
Mailing Address - Country:US
Mailing Address - Phone:585-758-7557
Mailing Address - Fax:585-637-5626
Practice Address - Street 1:156 WEST AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-1229
Practice Address - Country:US
Practice Address - Phone:585-758-7557
Practice Address - Fax:585-637-5626
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254972207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03324774Medicaid
NY03324774Medicaid