Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F302752-1 | NY |
N | 363LC1500X | Nurse Practitioner - Community Health | F302752-1 | NY |
N | 363LP2300X | Nurse Practitioner - Primary Care | F302752-1 | NY |
NPI | 1073874673 |
---|---|
Provider Name | Christine Montalbano-Kroon |
First Address | Staten Island, NY 10314-2418 |
Second Address | Staten Island, NY 10314-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2012 |
Last Update Date | 31/05/2012 |