Provider Demographics
NPI:1487305967
Name:KRISCH, CHRISTINE M (NP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:KRISCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 STUYVESANT OVAL APT 10E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2029
Mailing Address - Country:US
Mailing Address - Phone:516-946-3456
Mailing Address - Fax:
Practice Address - Street 1:520 E. 70TH STREET
Practice Address - Street 2:STARR 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:516-946-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309590363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health