Provider Demographics
NPI:1205389806
Name:KORMASH, CHRISTINE M
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:KORMASH
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 1:532 NORTH AVE
Mailing Address - Street 2:APT C
Mailing Address - City:DUNELLEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1082
Mailing Address - Country:US
Mailing Address - Phone:908-397-2098
Mailing Address - Fax:
Practice Address - Street 1:532 NORTH AVE
Practice Address - Street 2:APT C
Practice Address - City:DUNELLEN
Practice Address - State:NJ
Practice Address - Zip Code:08812-1082
Practice Address - Country:US
Practice Address - Phone:908-397-2098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst