Provider Demographics
NPI:1174051494
Name:YOHANNAN, CHRISTINA (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:YOHANNAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 HUDSON VALLEY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-4746
Mailing Address - Country:US
Mailing Address - Phone:845-220-2270
Mailing Address - Fax:845-220-2277
Practice Address - Street 1:575 HUDSON VALLEY AVE STE 201
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-4746
Practice Address - Country:US
Practice Address - Phone:845-220-2270
Practice Address - Fax:845-220-2277
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine