Healthcare Provider Details

I. General information

NPI: 1831570589
Provider Name (Legal Business Name): CHRISTINE HOANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 7TH AVE
NEW YORK NY
10011-6629
US

IV. Provider business mailing address

30 7TH AVE
NEW YORK NY
10011-6629
US

V. Phone/Fax

Practice location:
  • Phone: 479-629-6505
  • Fax:
Mailing address:
  • Phone: 718-470-8582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number300745
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: