Provider Demographics
NPI:1770588410
Name:HESLOP, CHRISTINE J (CNM)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:J
Last Name:HESLOP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E 106TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4007
Mailing Address - Country:US
Mailing Address - Phone:212-360-2600
Mailing Address - Fax:
Practice Address - Street 1:212 E 106TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4007
Practice Address - Country:US
Practice Address - Phone:212-360-2600
Practice Address - Fax:212-360-2618
Is Sole Proprietor?:No
Enumeration Date:2005-06-18
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291392-1163W00000X
NYF000536-1367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00355151Medicaid
NY00355151Medicaid