Individual
CHRISTINA MARIE HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
333 ROUTE 25A, ROCKY POINT, NY 11778-8556
(631) 744-3671
(631) 744-6205
Mailing address
464 NICHOLS RD, HAUPPAUGE, NY 11788-5013
(631) 979-9436
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
501428-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
501428-1
REGISTRATION CERTIFICATE
NY
Enumeration date
03/08/2007
Last updated
07/08/2007
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