Healthcare Provider Details

I. General information

NPI: 1790606416
Provider Name (Legal Business Name): CHRISTIAN BONE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 30TH AVE APT 6
ASTORIA NY
11103-4376
US

IV. Provider business mailing address

3701 30TH AVE APT 6
ASTORIA NY
11103-4376
US

V. Phone/Fax

Practice location:
  • Phone: 903-352-6198
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131879
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: