Healthcare Provider Details

I. General information

NPI: 1235049693
Provider Name (Legal Business Name): CHRISTINE SUYEON GAMBINO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N MAIN ST
PENNINGTON NJ
08534-2223
US

IV. Provider business mailing address

32 AZALEA CT
LAWRENCE TOWNSHIP NJ
08648-4815
US

V. Phone/Fax

Practice location:
  • Phone: 609-275-5700
  • Fax:
Mailing address:
  • Phone: 551-502-6008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ15655600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: