Provider Demographics
NPI:1053748053
Name:MICHAEL, CHRISTINE R (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27 SOUTH COOKS BRIDGE ROAD
Mailing Address - Street 2:SUITE 2-7
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2524
Mailing Address - Country:US
Mailing Address - Phone:732-897-5545
Mailing Address - Fax:732-987-5549
Practice Address - Street 1:3499 ROUTE 9 N
Practice Address - Street 2:SUITE 2B
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3258
Practice Address - Country:US
Practice Address - Phone:732-625-3166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09935200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine