Healthcare Provider Details

I. General information

NPI: 1740129162
Provider Name (Legal Business Name): CHRISTINE TAWFIK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RIVERVIEW PLZ
RED BANK NJ
07701-1864
US

IV. Provider business mailing address

3 WYNCREST RD
MARLBORO NJ
07746-1103
US

V. Phone/Fax

Practice location:
  • Phone: 732-741-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP01009400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: