Healthcare Provider Details

I. General information

NPI: 1285062380
Provider Name (Legal Business Name): CHRISTINA KURIEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 NORTHERN BLVD
GREAT NECK NY
11021-5207
US

IV. Provider business mailing address

2882 ANDERSON ST
WANTAGH NY
11793-2328
US

V. Phone/Fax

Practice location:
  • Phone: 516-723-2663
  • Fax:
Mailing address:
  • Phone: 516-312-9671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number016723
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: