Healthcare Provider Details

I. General information

NPI: 1134479488
Provider Name (Legal Business Name): CHRISTINA EILEEN MCGRISKEN RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA ROHAN RN, FNP

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 BAINBRIDGE AVE
BRONX NY
10467-2403
US

IV. Provider business mailing address

111 E 210TH ST
BRONX NY
10467-2401
US

V. Phone/Fax

Practice location:
  • Phone: 718-741-2342
  • Fax:
Mailing address:
  • Phone: 718-741-2342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number662506
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number342838
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number342838
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: