Individual
CHRISTIAN DEFOURNOY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1880 HYLAN BLVD STE 2R14, STATEN ISLAND, NY 10305-2116
(929) 312-1468
Mailing address
845 CASTLETON AVE, STATEN ISLAND, NY 10310-1808
(929) 312-1468
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
719660
NY
164W00000X
Licensed Practical Nurse
289076
NY
363LF0000X
Family Nurse Practitioner
Primary
F351785
NY
Other
Enumeration date
10/19/2009
Last updated
11/07/2025
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