| Doctor Name: | MRS. CHRISTINE MARIE WALL |
| NPI Number: | 1003976481 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 528246-1 |
| Business Practice Address: | 29 Pagnotta Dr Port Jefferson Station, NY - 117764454 |
| Business Phone Number: | 6318282905 |
| Business Fax Number: | |
| Mailing Address: | 29 Pagnotta Dr, PORT JEFFERSON STATION |
| State: | NY |
| Postal Code: | 117764454 |
| Phone Number: | 6318282905 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 528246-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |