Provider Demographics
NPI:1700130119
Name:SULIK, CHRISTI MOOT (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTI
Middle Name:MOOT
Last Name:SULIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2436
Mailing Address - Country:US
Mailing Address - Phone:518-439-8886
Mailing Address - Fax:
Practice Address - Street 1:700 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-2436
Practice Address - Country:US
Practice Address - Phone:518-439-8886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY579646163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse