Provider Demographics
NPI:1639197130
Name:O'HAGAN CARLIN, CHRISTINE M (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:M
Last Name:O'HAGAN CARLIN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 BEACH 134TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1440
Mailing Address - Country:US
Mailing Address - Phone:631-355-4646
Mailing Address - Fax:718-474-7957
Practice Address - Street 1:238 BEACH 134TH ST
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1440
Practice Address - Country:US
Practice Address - Phone:631-355-4646
Practice Address - Fax:718-474-7957
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007082363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY970025820Medicare PIN
NYP07838Medicare UPIN
NY0271ERMedicare PIN