Provider Demographics
NPI:1255900320
Name:DR. CHRISTINA VAGLICA PSYCHIATRY, P.C.
Entity type:Organization
Organization Name:DR. CHRISTINA VAGLICA PSYCHIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:VAGLICA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-864-7560
Mailing Address - Street 1:10 FULLER ST
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6656
Mailing Address - Country:US
Mailing Address - Phone:917-864-7560
Mailing Address - Fax:631-665-0709
Practice Address - Street 1:212 5TH AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6408
Practice Address - Country:US
Practice Address - Phone:917-864-7560
Practice Address - Fax:631-665-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty