Provider Demographics
NPI:1922857093
Name:SANCHEZ, CHRISTINE IVETTE (BBA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:IVETTE
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:BBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-3298
Mailing Address - Country:US
Mailing Address - Phone:973-352-7941
Mailing Address - Fax:
Practice Address - Street 1:764 MAIN ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-3298
Practice Address - Country:US
Practice Address - Phone:862-282-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01101100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty