Provider Demographics
NPI:1942759352
Name:PFUNDSTEIN, CHRISTINE (PNP, CCE, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:PFUNDSTEIN
Suffix:
Gender:F
Credentials:PNP, CCE, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2726
Mailing Address - Country:US
Mailing Address - Phone:516-521-2038
Mailing Address - Fax:
Practice Address - Street 1:111 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2420
Practice Address - Country:US
Practice Address - Phone:631-928-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY604599-1163WL0100X
NY383001363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant