Provider Demographics
NPI:1891052643
Name:BURNS, CHRISTINA (DOM)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 10TH AVE
Mailing Address - Street 2:APPT 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7000
Mailing Address - Country:US
Mailing Address - Phone:347-987-8994
Mailing Address - Fax:
Practice Address - Street 1:1045 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0138
Practice Address - Country:US
Practice Address - Phone:347-987-8994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004772171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist