MEDICARE: CHRISTINE THERESE ROHAN FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	335180	NY

General Provider Information

NPI Number	:	1033473947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE THERESE ROHAN FNP-BC

Provider Business Mailing Address
First Line	:	8 ORCHARD HEIGHTS DR
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-1334
Country	:	US
Telephone Number	:	845-787-4096
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 ORCHARD HEIGHTS DR
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-1334
Country	:	US
Telephone Number	:	845-787-4096
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2012
Last Update Date	:	06/26/2012

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