Individual
CHRISTY K DEFOURNOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
68 JEFFERSON AVE, BAY SHORE, NY 11706-5760
(631) 482-0219
Mailing address
2053 23RD ST, ASTORIA, NY 11105-3245
(631) 626-6796
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
347189
NY
Other
Enumeration date
08/15/2011
Last updated
01/06/2022
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