Healthcare Provider Details

I. General information

NPI: 1700133832
Provider Name (Legal Business Name): CHRISTINE ANIELA PIPCHICK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 70TH ST
NEW YORK NY
10023-3504
US

IV. Provider business mailing address

300 W 108TH ST APT 13A
NEW YORK NY
10025-2788
US

V. Phone/Fax

Practice location:
  • Phone: 212-280-4740
  • Fax:
Mailing address:
  • Phone: 646-245-4773
  • Fax: 212-280-4743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00288800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number015689
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: