Provider Demographics
NPI:1871639815
Name:NG, CHRISTINA HOLIDAY (MSPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:HOLIDAY
Last Name:NG
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 KNIGHTSBRIDGE RD
Mailing Address - Street 2:APT. 1H
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4540
Mailing Address - Country:US
Mailing Address - Phone:718-551-6711
Mailing Address - Fax:
Practice Address - Street 1:35 KNIGHTSBRIDGE RD
Practice Address - Street 2:APT. 1H
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4540
Practice Address - Country:US
Practice Address - Phone:718-551-6711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025999-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor