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General NPI Number Information
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NPI Number | 1215746268
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Entity Type | Individual
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Provider Name | CRISTINE JEANG
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Gender | Female
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Dates
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Enumeration Date | 01/04/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 13347 SANFORD AVE STE 1F
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City | FLUSHING
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State | NY
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Zip | 11355-5816
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Country | US
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Telephone | 718-359-5780
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Fax |
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Provider Business Mailing Address
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Address Line | 7150 PARSONS BLVD APT 2L
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City | FLUSHING
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State | NY
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Zip | 11365-4101
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Country | US
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Telephone | 917-515-2828
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 356038
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License Number State | NY
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