Provider Demographics
NPI:1972041853
Name:FAUST, CHRISTINE (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:FAUST
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5130 EAST MAIN ST. RD.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020
Mailing Address - Country:US
Mailing Address - Phone:585-344-1421
Mailing Address - Fax:
Practice Address - Street 1:5120 EAST MAIN ST. RD.
Practice Address - Street 2:SUITE 2
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020
Practice Address - Country:US
Practice Address - Phone:585-344-1421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program