Provider Demographics
NPI:1457547788
Name:GARB, CHRISTIE DOROTHY (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:DOROTHY
Last Name:GARB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 ROUTE 44
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-5503
Mailing Address - Country:US
Mailing Address - Phone:845-409-8204
Mailing Address - Fax:845-603-9908
Practice Address - Street 1:2608 ROUTE 44
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545-5503
Practice Address - Country:US
Practice Address - Phone:845-409-8204
Practice Address - Fax:845-603-9908
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03530389Medicaid
NYP01197238OtherMEDICARE RAILROAD
NYP01197238OtherMEDICARE RAILROAD