Provider Demographics
NPI:1629301999
Name:DORN-MOLDOVAN, CHRISTINE (RN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:DORN-MOLDOVAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:DORN-RIZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:26 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKHOLM
Mailing Address - State:NJ
Mailing Address - Zip Code:07460
Mailing Address - Country:US
Mailing Address - Phone:516-236-9361
Mailing Address - Fax:
Practice Address - Street 1:53 GIBSON RD
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924
Practice Address - Country:US
Practice Address - Phone:845-291-0200
Practice Address - Fax:845-291-0198
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY379190-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse