Provider Demographics
NPI:1700133832
Name:PIPCHICK, CHRISTINE ANIELA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANIELA
Last Name:PIPCHICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 108TH ST APT 13A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2788
Mailing Address - Country:US
Mailing Address - Phone:646-245-4773
Mailing Address - Fax:212-280-4743
Practice Address - Street 1:315 W 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3504
Practice Address - Country:US
Practice Address - Phone:212-280-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00288800363A00000X
NY015689363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY015689-01OtherNYS LICENSE
NJ25MP00288800OtherNJ STATE LICENSE