Individual provider Active NPI

Christine Clifford, M.S

  • Specialist
  • Wading River, NY
National Provider Identifier
1700311537
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
12 Deerfield Dr
Wading River, NY 11792-2201
Phone
(631) 209-0899
NPI assigned
Apr 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NY Primary

Addresses

Primary practice location

12 Deerfield Dr
Wading River, NY 11792-2201

Mailing address

12 Deerfield Dr
Wading River, NY 11792-2201
Phone (631) 209-0899

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)
Not enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1493510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700311537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 DEERFIELD DR",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922201",
            "telephone_number": "631-209-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DEERFIELD DR",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922201",
            "telephone_number": "631-209-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.