Provider Demographics
NPI:1154722783
Name:PAGE, CHRISTINE ELIZABETH
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:PAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2513
Mailing Address - Country:US
Mailing Address - Phone:845-323-7792
Mailing Address - Fax:
Practice Address - Street 1:146 GROVE ST
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2513
Practice Address - Country:US
Practice Address - Phone:845-323-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY688268-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse