CHRISTINA WAICULONIS (NPI# 1346677366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346677366 |
| Entity Type | Individual |
| Full Name | CHRISTINA WAICULONIS |
| Credential | PA-C |
| Practice Address |
260 Riverside Dr Johnson City NY 13790-2798 |
| Practice Telephone | 6077987811 |
| Practice Fax Number | 6077707035 |
| Mailing Telephone | 6077987811 |
| Mailing Fax Number | 6077707035 |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
017014 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
260 RIVERSIDE DR |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790-2798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669463691 | Asha Gupta | Allergy & Immunology | 260 Riverside Dr, Johnson City, NY 13790-2727 | 2005-10-31 |
| 1063828374 | Riverbend Family Dental | Dentist | 260 Riverside Dr, Johnson City, NY 13790-2745 | 2014-07-08 |
| 1063662930 | David A. Rogers | Dentist | 260 Riverside Dr, Johnson City, NY 13790 | 2008-09-26 |
| 1699961185 | Asha Gupta, Md | Allergy & Immunology | 260 Riverside Dr, Johnson City, NY 13790-2745 | 2007-09-19 |
| 1417141607 | Barret T J. Raff,dds | Dentist | 260 Riverside Dr, Johnson City, NY 13790-2745 | 2007-08-30 |
| 1023032729 | Jennifer Anne Shattuck | Nurse Practitioner | 260 Riverside Dr, Johnson City, NY 13790-2745 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083965651 | Shalena Peterson | Physician Assistant | 301 Med Tech Pkwy Ste 280, Johnson City, TN 37604-2364 | 2012-09-24 |
| 1063544716 | Christine Turbyfill Kinley | Physician Assistant | 3741 W Market St, Johnson City, TN 37604 | 2007-03-09 |
| 1508877416 | Pamela B Davis | Physician Assistant | 1627 Old Gray Station Rd, Ste 4, Johnson City, TN 37615-4193 | 2006-08-10 |
| 1437166477 | Thomas Alan Frantzen | Physician Assistant | Corner of Sidney and Lamont Streets, Johnson City, TN 37684-4000 | 2006-08-02 |
| 1700828977 | Melvin James Willis | Physician Assistant | James H Quillen/va Medical Center, Coner of Sidney & Lamont, Johnson City, TN 37684 | 2006-06-12 |
| 1902888944 | Bryan Daniel Lorch | Physician Assistant | 2514 Wesley St, 102, Johnson City, TN 37601-1764 | 2005-11-16 |
| 1386268159 | James Owen Thigpen | Physician Assistant | 410 N State of Franklin Rd Ste 130, Johnson City, TN 37604-6972 | 2020-06-08 |
| 1841814803 | Anthony Brian Jones | Physician Assistant | 2428 Knob Creek Rd Ste 102, Johnson City, TN 37604-2396 | 2020-06-04 |
| 1790319317 | Frances Wilson | Physician Assistant | 401 E Watauga Ave, Johnson City, TN 37601-4036 | 2020-02-24 |
| 1841741196 | Grace Internal Medicine, LLC | Physician Assistant | 2514 Wesley St, Suite 102, Johnson City, TN 37601-1764 | 2016-10-21 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
Please comment or provide details below to improve the information on CHRISTINA WAICULONIS.
| 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.