Individual provider Active NPI

Christine McLoughlin, ANP

  • Adult Health Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1649660002
Registry record updated Sep 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306643 Issued in NY
Practice address
269 Atlantic Ave
Staten Island, NY 10305-1335
Phone
(718) 702-6976
Fax
(718) 979-7771
NPI assigned
Jan 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 306643 NY Primary

Addresses

Primary practice location

269 Atlantic Ave
Staten Island, NY 10305-1335

Mailing address

4802 10TH Avenue
Brooklyn, NY 11219
Phone (718) 283-7957

Other names 1

  • Ms. Christine Defalco Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1649660002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-7957",
            "fax_number": "718-283-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 ATLANTIC AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051335",
            "telephone_number": "718-702-6976",
            "fax_number": "718-979-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLOUGHLIN",
        "first_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "DEFALCO",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.