Provider Demographics
NPI:1851527543
Name:ROQUE-DANG, CHRISTINE M (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:ROQUE-DANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 419430
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-9430
Mailing Address - Country:US
Mailing Address - Phone:201-967-8221
Mailing Address - Fax:201-967-0340
Practice Address - Street 1:466 OLD HOOK RD STE 1
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1368
Practice Address - Country:US
Practice Address - Phone:201-967-8221
Practice Address - Fax:201-967-0340
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09077800208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation