Christian Thomas Racine, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

017090 Issued in NY

Practice address

11 Route 111
Smithtown, NY 11787-3712

Phone

(631) 920-8300

Fax

(631) 920-8460

NPI assigned

Mar 25, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619094430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 FULTON ST",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117553043",
            "telephone_number": "631-467-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROUTE 111",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873712",
            "telephone_number": "631-920-8300",
            "fax_number": "631-920-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACINE",
        "first_name": "CHRISTIAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Quintana, APRN
• Susan M Quintin, OTR/L
• Gina Quiocho, RN
• Katelyn Quiroga
• Rachel Lessard LCSW PC
• Valentina Emilia Radianu, MD
• Retta A Radin, MS, NCC, LMHC
• Radiologic Health Services MRI of Smithtown PC
• Radiology Health Services, PC
• Grace Radner, PHYSICAL THERAPIST

• Clinical Psychologist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.