Healthcare Provider Details

I. General information

NPI: 1992446066
Provider Name (Legal Business Name): CHRISTOPHER GEORGE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 HUNTERS POINT AVE STE 2L
LONG ISLAND CITY NY
11101-2524
US

IV. Provider business mailing address

3245 HUNTERS POINT AVE STE 2L
LONG ISLAND CITY NY
11101-2524
US

V. Phone/Fax

Practice location:
  • Phone: 855-895-3380
  • Fax:
Mailing address:
  • Phone: 855-895-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number343739
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: