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General NPI Number Information
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NPI Number | 1033317664
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Entity Type | Individual
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Provider Name | CHRISTINE MARIE CERVINI NP
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1305 YORK AVENUE RM 4-30
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 646-962-4718
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Fax | 646-962-0377
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Provider Business Mailing Address
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Address Line | 6860 108TH ST APT 1 H
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City | FOREST HILLS
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State | NY
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Zip | 11375-2973
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Country | US
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Telephone | 718-577-9862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 304015
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License Number State | NY
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