Healthcare Provider Details

I. General information

NPI: 1255711826
Provider Name (Legal Business Name): CHRISTINA MARIA GANESHALINGAM D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA MARIA HAMM D.O.

II. Dates (important events)

Enumeration Date: 06/09/2015
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MEETING HOUSE LN
SOUTHAMPTON NY
11968-5009
US

IV. Provider business mailing address

1345 RXR PLZ
UNIONDALE NY
11556-1301
US

V. Phone/Fax

Practice location:
  • Phone: 631-726-8200
  • Fax:
Mailing address:
  • Phone: 516-453-0435
  • 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 StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number291906
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: