Healthcare Provider Details

I. General information

NPI: 1942467352
Provider Name (Legal Business Name): CHRISTY ANN STANAT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTY ANN ADAMSKY M.D.

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 11/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CASE ST
NORWICH CT
06360-2222
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 860-204-9126
  • Fax:
Mailing address:
  • Phone: 631-560-5027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD444280
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC149810
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number50908
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: