Provider Demographics
NPI:1841701232
Name:ELLIOTT-NEGRI, CHRISTINE MARIE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:ELLIOTT-NEGRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:NEGRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, MPH
Mailing Address - Street 1:442 STERLING PL APT 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4511
Mailing Address - Country:US
Mailing Address - Phone:516-780-1489
Mailing Address - Fax:516-780-1489
Practice Address - Street 1:1125 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-2669
Practice Address - Country:US
Practice Address - Phone:347-226-9025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095869-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker