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General NPI Number Information
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NPI Number | 1447399159
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Entity Type | Individual
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Provider Name | CHRISTINE GIBBONS M.S., C.A.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 221 W PASSAIC ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3120
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Country | US
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Telephone | 201-843-3366
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Fax | 201-843-0331
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Provider Business Mailing Address
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Address Line | 221 W PASSAIC ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3120
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Country | US
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Telephone | 201-843-3366
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Fax | 201-843-0331
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00014300
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License Number State | NJ
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