Provider Demographics
NPI:1659495620
Name:DUNNE, CHRISTA (M D)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:DUNNE
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 S MANNING BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1708
Mailing Address - Country:US
Mailing Address - Phone:518-437-5970
Mailing Address - Fax:518-437-5975
Practice Address - Street 1:314 S MANNING BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1708
Practice Address - Country:US
Practice Address - Phone:518-437-5970
Practice Address - Fax:518-437-5975
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210430207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1212017OtherWELLCARE
NY001921065OtherUNITED HEALTHCARE
NY01895472Medicaid
NY110038249003OtherCDPHP
NY5006111OtherMVP
NY848L81OtherEMPIRE BLUE CROSS BLUE SHIELD
NY5006111OtherMVP
NY95506OtherSHARED HEALTH
NY2596739OtherGHI
NY004950071OtherSENIOR BLUE
NY210430-5OtherWORKERS' COMP
NY43799OtherGHI-HMO
NY10038249OtherCDPHP