MEDICARE: MS. CHRISTINE MARIE MOHR NP

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	F348654-01	NY

General Provider Information

NPI Number	:	1629714662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE MARIE MOHR NP

Provider Business Mailing Address
First Line	:	666 GRAND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-4887
Country	:	US
Telephone Number	:	718-963-0555
Fax Number	:	718-963-4889

Provider Business Practice Location Address
First Line	:	247 GRAND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-4302
Country	:	US
Telephone Number	:	718-782-4768
Fax Number	:	718-782-3677

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

Provider Enumeration Date	:	05/11/2022
Last Update Date	:	12/11/2025

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