Healthcare Provider Details

I. General information

NPI: 1528986932
Provider Name (Legal Business Name): CHRISTINE MARIE O'DONOGHUE-KITT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
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: 631-405-7515
  • Fax:
Mailing address:
  • Phone: 631-405-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINE MARIE O'DONOGHUE-KITT
Title or Position: OWNER EMPLOYEE
Credential: MD
Phone: 631-405-7515