Individual
CHRISTINA WAICULONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
260 RIVERSIDE DR, JOHNSON CITY, NY 13790-2798
(607) 798-7811
(607) 770-7035
Mailing address
260 RIVERSIDE DR, JOHNSON CITY, NY 13790-2798
(607) 798-7811
(607) 770-7035
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
017014
NY
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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