1255432928 NPI number — DR. CHRISTINA E. GENERIE OD

Table of content: MELISSA MONROY (NPI 1306938451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255432928 NPI number — DR. CHRISTINA E. GENERIE OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GENERIE
Provider First Name:
CHRISTINA
Provider Middle Name:
E.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHO
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
E.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255432928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6230 OLD DOBBIN LN STE 190
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21045-5954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-420-8113
Provider Business Mailing Address Fax Number:
443-973-6998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6230 OLD DOBBIN LN STE 190
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21045-5954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-420-8113
Provider Business Practice Location Address Fax Number:
443-973-6998
Provider Enumeration Date:
09/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  DA1997 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: OP1000119 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: TA1997 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 11625596 . This is a "CAQH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".