MEDICARE: CHRISTINE MAI

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	207N00000X	Dermatology Physician	035005	NY

General Provider Information

NPI Number	:	1295532752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MAI

Provider Business Mailing Address
First Line	:	1041 47TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5416
Country	:	US
Telephone Number	:	212-385-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1041 47TH AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5416
Country	:	US
Telephone Number	:	212-385-3700
Fax Number	:

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

Provider Enumeration Date	:	03/03/2025
Last Update Date	:	03/29/2026

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Directions to “ CHRISTINE MAI ” Practice Location

Language	Start Address	Practice Location

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