Healthcare Provider Details

I. General information

NPI: 1346651890
Provider Name (Legal Business Name): CHRISTINA MARIE ESCOBAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2014
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E 41ST ST
NEW YORK NY
10017-6739
US

IV. Provider business mailing address

401 E 34TH ST APT S29E
NEW YORK NY
10016-4914
US

V. Phone/Fax

Practice location:
  • Phone: 646-825-6300
  • Fax: 646-825-6399
Mailing address:
  • Phone: 813-766-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number295328
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number295328
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: