Provider Demographics
NPI:1932215993
Name:MCCLOSKEY, CHRISTIANE MARIE (CM, MS)
Entity Type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:MARIE
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:CM, MS
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Other - Credentials:
Mailing Address - Street 1:760 BROADWAY DEPARTMANT OF MANAGED CARE ROOM 2B230
Mailing Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8000
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:WOODHULL MEDICAL & MENTAL HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-966-8000
Practice Address - Fax:718-369-6229
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2014-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF001078367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1992692559OtherCORPORATE NPI