Provider Demographics
NPI:1013270941
Name:GARNEAU, CHRISTINE M (MS)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:M
Last Name:GARNEAU
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:5403 MAIN ST.
Mailing Address - City:DURHAMVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13054-0163
Mailing Address - Country:US
Mailing Address - Phone:315-363-4976
Mailing Address - Fax:
Practice Address - Street 1:5403 MAIN ST
Practice Address - Street 2:BOX 163
Practice Address - City:DURHAMVILLE
Practice Address - State:NY
Practice Address - Zip Code:13054-0163
Practice Address - Country:US
Practice Address - Phone:315-363-4976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist