MEDICARE: CHRISTINA JURGIELEWICZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	189504	CA

General Provider Information

NPI Number	:	1063161362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA JURGIELEWICZ MD

Provider Business Mailing Address
First Line	:	1436 JACKSON AVE APT 1A
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-5774
Country	:	US
Telephone Number	:	504-232-3773
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N STATE ST # A7D
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-1001
Country	:	US
Telephone Number	:	323-409-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	04/24/2026

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