Provider Demographics
NPI:1689806341
Name:RASMUSSEN, CHRISTINE A (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 GRAND CONCOURSE
Mailing Address - Street 2:BRONXCARE WOMENS HEALTH CLINIC 14TH FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456
Mailing Address - Country:US
Mailing Address - Phone:718-518-5000
Mailing Address - Fax:
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:BRONXCARE WOMENS HEALTH CLINIC 14TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456
Practice Address - Country:US
Practice Address - Phone:718-518-5000
Practice Address - Fax:718-340-3074
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336055363LN0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03198010Medicaid