Provider Demographics
NPI:1013325802
Name:LEMEN, CHRISTINE MARIE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:LEMEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MIDDLETON RD
Mailing Address - Street 2:APT 9
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-3925
Mailing Address - Country:US
Mailing Address - Phone:631-512-2393
Mailing Address - Fax:
Practice Address - Street 1:80 MIDDLETON RD
Practice Address - Street 2:APT 9
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-3925
Practice Address - Country:US
Practice Address - Phone:631-512-2393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist