Provider Demographics
NPI:1760927388
Name:MINGIONE, CRISTINA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:MINGIONE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7914 GLENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1032
Mailing Address - Country:US
Mailing Address - Phone:718-598-1096
Mailing Address - Fax:
Practice Address - Street 1:470 MAMARONECK AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1830
Practice Address - Country:US
Practice Address - Phone:914-421-8270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63021180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist