Provider Demographics
NPI:1871536813
Name:MASTERSON, CHRISTINE (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:SUMMIT MEDICAL GROUP
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:908-219-3011
Practice Address - Street 1:890 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1218
Practice Address - Country:US
Practice Address - Phone:908-277-8799
Practice Address - Fax:908-608-2376
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA66443207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH09003Medicare UPIN
NJ124663Medicare ID - Type Unspecified