Provider Demographics
NPI:1295176949
Name:BUCK-ZERMANE, CHRISTINA ROSE (ECSE DEVELOPMENTAL)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ROSE
Last Name:BUCK-ZERMANE
Suffix:
Gender:F
Credentials:ECSE DEVELOPMENTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 CODDINGTON AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5926
Mailing Address - Country:US
Mailing Address - Phone:718-239-8239
Mailing Address - Fax:
Practice Address - Street 1:2865 CODDINGTON AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5926
Practice Address - Country:US
Practice Address - Phone:718-239-8239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2024-06-27
Deactivation Date:2022-11-18
Deactivation Code:
Reactivation Date:2024-06-27
Provider Licenses
StateLicense IDTaxonomies
CT222Q00000X
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist