Basic Information
| Provider Information | |||||||||
| NPI: | 1841411576 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUGAN | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | ALEXIS | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CPNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1465 MADISON AVE | ||||||||
| Address2: | 4TH FLOOR ROOM 4-89 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126598060 | ||||||||
| FaxNumber: | 2122412064 | ||||||||
| Practice Location | |||||||||
| Address1: | 1465 MADISON AVE | ||||||||
| Address2: | 4TH FLOOR ROOM 4-89 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100296511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126598060 | ||||||||
| FaxNumber: | 2122412064 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | F381502 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.