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NPI Code Detail

MEDICARE: MS. CHRISTINE ANNE MILLARE PA

MEDICARE: MS. CHRISTINE ANNE MILLARE PA
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
1363A00000XPhysician Assistant010530NY
2363AM0700XMedical Physician Assistant1066480CA

General Provider Information

NPI Number : 1992854780
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE ANNE MILLARE PA
Provider Business Mailing Address
First Line : 1275 YORK AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10065-6007
Country : US
Telephone Number : 212-639-5154
Fax Number :
Provider Business Practice Location Address
First Line : 415 OLD NEWPORT BLVD STE 200
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4252
Country : US
Telephone Number : 949-548-9611
Fax Number : 949-548-9958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 11/21/2022

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Directions to “ MS. CHRISTINE ANNE MILLARE PA” Practice Location

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