Basic Information
Provider Information
NPI: 1518161983
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TREECE
FirstName: CHRISTINA
MiddleName: ANNETTE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1245 PARK AVE
Address2: APARTMENT 19A
City: NEW YORK
State: NY
PostalCode: 101281735
CountryCode: US
TelephoneNumber: 6469427277
FaxNumber: 2127467166
Practice Location
Address1: 119 W 24TH ST
Address2: FIRST FLOOR
City: NEW YORK
State: NY
PostalCode: 100111913
CountryCode: US
TelephoneNumber: 2127467200
FaxNumber: 2127467166
Other Information
ProviderEnumerationDate: 06/12/2007
LastUpdateDate: 10/30/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X229426NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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