Provider Demographics
NPI:1992859151
Name:MAURO, CHRISTIANE MARIE (LAC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIANE
Middle Name:MARIE
Last Name:MAURO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 W 14TH ST
Mailing Address - Street 2:201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7489
Mailing Address - Country:US
Mailing Address - Phone:917-673-4747
Mailing Address - Fax:212-691-5198
Practice Address - Street 1:39 W 14TH ST
Practice Address - Street 2:201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7489
Practice Address - Country:US
Practice Address - Phone:917-673-4747
Practice Address - Fax:212-691-5198
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002866171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist