Healthcare Provider Details

I. General information

NPI: 1306039482
Provider Name (Legal Business Name): CHRISTINE MARIE O'DONOGHUE- KITT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887 OLD COUNTRY RD STE A
RIVERHEAD NY
11901-2115
US

IV. Provider business mailing address

55 WINDFLOWER LN
RIVERHEAD NY
11901-1407
US

V. Phone/Fax

Practice location:
  • Phone: 631-404-7515
  • Fax:
Mailing address:
  • Phone: 516-458-5654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number259158-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: