Provider Demographics
NPI:1134161193
Name:ADAMS, CRISTINE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CRISTINE
Middle Name:MARIE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CRISTINE
Other - Middle Name:MARIE
Other - Last Name:CONNERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1522
Mailing Address - Country:US
Mailing Address - Phone:163-101-1017
Mailing Address - Fax:
Practice Address - Street 1:77 GOODELL ST STE 340
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1243
Practice Address - Country:US
Practice Address - Phone:716-645-9700
Practice Address - Fax:716-645-9701
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2313721207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02669661Medicaid
NY3994769OtherINDEPENDENT HEALTH
NY00027210701OtherUNIVERA HEALTHCARE
NY51004000014OtherFIDELIS
NY000528189001OtherBLUE CROSS BLUE SHIELD
NYP00230357OtherRAILROAD MEDICARE
NYRA7573Medicare ID - Type Unspecified
NYP00230357OtherRAILROAD MEDICARE