Basic Information
| Provider Information | |||||||||
| NPI: | 1598019937 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESTRADA | ||||||||
| FirstName: | CHRISTIAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 185 S ORANGE AVE | ||||||||
| Address2: | MSB-E547 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071032757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084256378 | ||||||||
| FaxNumber: | 9739723835 | ||||||||
| Practice Location | |||||||||
| Address1: | 185 S ORANGE AVE | ||||||||
| Address2: | MSB-E547 | ||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071032757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084256378 | ||||||||
| FaxNumber: | 9739723835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2012 | ||||||||
| LastUpdateDate: | 08/03/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 25MA09918800 | NJ | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.