Healthcare Provider Details

I. General information

NPI: 1114101409
Provider Name (Legal Business Name): CHRISTINE CAROL TINTORER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S HOLMDEL RD STE 5
HOLMDEL NJ
07733-2614
US

IV. Provider business mailing address

22 S HOLMDEL RD STE 5
HOLMDEL NJ
07733-2614
US

V. Phone/Fax

Practice location:
  • Phone: 732-444-1330
  • Fax: 732-444-1331
Mailing address:
  • Phone: 732-444-1330
  • Fax: 732-444-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number242476
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number25MA08765900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD475006
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number242476
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: