Provider Demographics
NPI:1356382501
Name:MAND, CHRISTINE P (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:P
Last Name:MAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:MATHENY MEDICAL AND EDUCATIONAL CENTER
Mailing Address - Street 2:HIGHLAND AVENUE
Mailing Address - City:PEAPACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07977
Mailing Address - Country:US
Mailing Address - Phone:908-234-0011
Mailing Address - Fax:908-234-2635
Practice Address - Street 1:MATHENY MEDICAL AND EDUCATIONAL CENTER
Practice Address - Street 2:HIGHLAND AVENUE
Practice Address - City:PEAPACK
Practice Address - State:NJ
Practice Address - Zip Code:07977
Practice Address - Country:US
Practice Address - Phone:908-234-0011
Practice Address - Fax:908-234-2635
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05861800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7238002Medicaid
NJG45889Medicare UPIN
NJ7238002Medicaid