Provider Demographics
NPI:1669782314
Name:TENORIO, CHRISTINE UBUNGEN (OT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:UBUNGEN
Last Name:TENORIO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 MAYFLOWER AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:917-640-4503
Mailing Address - Fax:718-518-1244
Practice Address - Street 1:1894 EASTCHESTER ROAD
Practice Address - Street 2:
Practice Address - City:BRONX,
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-518-1133
Practice Address - Fax:718-518-1244
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist