Provider Demographics
NPI:1124715792
Name:PARRAGA, CHRISTIAN F (LAC)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:F
Last Name:PARRAGA
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 BRITTON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2454
Mailing Address - Country:US
Mailing Address - Phone:929-387-1848
Mailing Address - Fax:
Practice Address - Street 1:311 SAINT NICHOLAS AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-2296
Practice Address - Country:US
Practice Address - Phone:929-387-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007278171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty