Provider Demographics
NPI:1710169529
Name:WOODS, CHRISTINE M (NP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:M
Last Name:WOODS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DELACEY AVE
Mailing Address - Street 2:
Mailing Address - City:EAST QUOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11942-3012
Mailing Address - Country:US
Mailing Address - Phone:631-653-9297
Mailing Address - Fax:
Practice Address - Street 1:1 DELACEY AVE
Practice Address - Street 2:
Practice Address - City:EAST QUOGUE
Practice Address - State:NY
Practice Address - Zip Code:11942-3012
Practice Address - Country:US
Practice Address - Phone:631-653-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400517363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health