Individual
CHRISTA M EBONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
105 WOODCREST DR, RIFTON, NY 12471-7200
(845) 658-7763
Mailing address
10 HELLBROOK LN, ULSTER PARK, NY 12487-5209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004815
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01981635
—
NY
01
—
293859
HMO - WALDEN
NY
Enumeration date
03/04/2006
Last updated
03/07/2023
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