Provider Demographics
NPI:1508695008
Name:GORSKI-MAKAR, CHRISTINE ANNE MARIE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANNE MARIE
Last Name:GORSKI-MAKAR
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 1:25 HOLMES AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1339
Mailing Address - Country:US
Mailing Address - Phone:917-572-8570
Mailing Address - Fax:
Practice Address - Street 1:25 HOLMES AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1339
Practice Address - Country:US
Practice Address - Phone:917-572-8570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health