CHRISTY D STINE (NPI# 1053380618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053380618 |
| Entity Type | Individual |
| Full Name | CHRISTY D STINE |
| Other Name | CHRISTY D JOHNSON |
| Credential | M.D., PH.D. |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415348 Boston MA 02241-5348 |
| Practice Telephone | 7744418084 |
| Practice Fax Number | 5088564287 |
| Mailing Telephone | 8002258885 |
| Mailing Fax Number | 5083341977 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
226596 | MA | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
226596 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110041922A | 05 |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326314998 | Melanie Ann Mcnally | Psychiatry & Neurology | 55 Lake Ave N, Worcester, MA 01655-0002 | 2012-03-28 |
| 1609800267 | Brenda L.y. Wong | Psychiatry & Neurology | 55 Lake Ave N, Worcester, MA 01655-0002 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366963258 | Maria Antonietta Mazzola | Psychiatry & Neurology | 57 Manchester Rd, Brookline, MA 02446 | 2017-06-29 |
| 1548508252 | Adriana Mendez Sanchez | Psychiatry & Neurology | 771 Albany Street Boston Medical Center Child Neurology, Dowling 3 South Rm 3314, Boston, MA 02118 | 2013-01-30 |
| 1083909774 | Kristen A. Lindgren | Psychiatry & Neurology | Nwh Pediatric Ambulatory Care Center, 2014 Washington St, 6 South, Newton, MA 02462 | 2011-06-10 |
| 1124082714 | Rebeca N Alvareza-altalef | Psychiatry & Neurology | 750 Washington St # 330, Boston, MA 02111-1526 | 2006-04-12 |
| 1982670535 | Elizabeth Anne Thiele | Psychiatry & Neurology | 55 Fruit St Yaw 6b, Pediatric Neurology, Boston, MA 02114 | 2006-02-24 |
| 1205480043 | Lauren Sham | Psychiatry & Neurology | 300 Longwood Ave, Boston, MA 02115-5724 | 2019-07-30 |
| 1457848293 | Paul N. Chervin, M.d. LLC | Psychiatry & Neurology | 604 Main Street, Woburn, MA 01801 | 2018-04-17 |
| 1386164101 | Ashley Weng | Psychiatry & Neurology | 800 Washington St, Boston, MA 02111 | 2017-06-22 |
| 1922554872 | Kristen Lindgren Md Phd LLC | Psychiatry & Neurology | 2014 Washington St, Newton-wellesley Hospital, Pediatric Ambulatory Clinic, Newton, MA 02462-1607 | 2016-08-31 |
| 1891148854 | Jose Ildefonso Rodriguez Moreno | Psychiatry & Neurology | 800 Washington St, Boston, MA 02111-1552 | 2016-07-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CHRISTY D STINE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.