Individual
CHRISTIANNE SUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(732) 735-1898
Mailing address
311 E 38TH ST, APT 18E, NEW YORK, NY 10016-2729
(732) 735-1898
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F430802-1
NY
Other
Enumeration date
04/30/2014
Last updated
02/04/2019
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