Provider Demographics
NPI:1780734244
Name:AHN, CHRISTINA Y (MD FACS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:Y
Last Name:AHN
Suffix:
Gender:F
Credentials:MD FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 EAST 72ND ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-717-8860
Mailing Address - Fax:855-975-0662
Practice Address - Street 1:530 EAST 72ND ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-717-8860
Practice Address - Fax:855-975-0662
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160844174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE89850Medicare UPIN
NY29L501Medicare ID - Type Unspecified
E83850Medicare UPIN