Provider Demographics
NPI:1679087464
Name:DILLON, CHRISTIE (MA EDUCATION)
Entity type:Individual
Prefix:MISS
First Name:CHRISTIE
Middle Name:
Last Name:DILLON
Suffix:
Gender:F
Credentials:MA EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2392
Mailing Address - Country:US
Mailing Address - Phone:631-838-4973
Mailing Address - Fax:
Practice Address - Street 1:229 LAUREL RD
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-1100
Practice Address - Country:US
Practice Address - Phone:631-659-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY408905628OtherDRIVER LICENSE
253200000XOther253200000X