Provider Demographics
NPI:1821507096
Name:ALAKA, CHRISTINE S (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:S
Last Name:ALAKA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1637
Mailing Address - Country:US
Mailing Address - Phone:646-750-6238
Mailing Address - Fax:
Practice Address - Street 1:219 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1637
Practice Address - Country:US
Practice Address - Phone:646-750-6238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021666363A00000X
NJ25MP00473300363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant