Individual
CHRISTINA THERESA WHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3767 RICHMOND AVE, STATEN ISLAND, NY 10312-3827
(718) 967-0359
Mailing address
35 W RALEIGH AVE, STATEN ISLAND, NY 10310-2744
(917) 621-6309
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
027071-1
NY
Other
Enumeration date
06/10/2018
Last updated
06/10/2018
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