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General NPI Number Information
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NPI Number | 1700568870
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Entity Type | Individual
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Provider Name | CHRISTINE AZEVEDO KYRITSIS DMD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 41-51 WILSON AVE STE 1-C
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City | NEWARK
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State | NJ
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Zip | 07105-3269
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Country | US
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Telephone | 973-344-7444
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Fax |
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Provider Business Mailing Address
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Address Line | 44 OAK ST
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City | NUTLEY
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State | NJ
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Zip | 07110-1325
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Country | US
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Telephone | 973-510-3540
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02991800
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License Number State | NJ
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