Provider Demographics
NPI:1538155395
Name:CURCIONE, CHRISTINA LEE (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LEE
Last Name:CURCIONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:LEE
Other - Last Name:HANKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2433 OAK VALLEY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-7602
Mailing Address - Country:US
Mailing Address - Phone:734-994-0100
Mailing Address - Fax:734-994-9625
Practice Address - Street 1:2433 OAK VALLEY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-7602
Practice Address - Country:US
Practice Address - Phone:734-994-0100
Practice Address - Fax:734-994-9625
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003876152W00000X, 152WC0802X, 152WP0200X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3403474Medicaid
MICC003876OtherBCBSM INDIVIDUAL PIN
MI3403474Medicaid