Healthcare Provider Details

I. General information

NPI: 1306778543
Provider Name (Legal Business Name): CHRISTINE SUSAN PARAMBIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MADISON AVE
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

540 N 11TH ST
NEW HYDE PARK NY
11040-4213
US

V. Phone/Fax

Practice location:
  • Phone: 646-605-4700
  • Fax:
Mailing address:
  • Phone: 516-754-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number359069
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: