Healthcare Provider Details

I. General information

NPI: 1689866410
Provider Name (Legal Business Name): CHRISTOPHER THOMAS RACZYNSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 42ND ST NW SUITE 310
WASHINGTON DC
20016-4623
US

IV. Provider business mailing address

4545 42ND ST NW SUITE 310
WASHINGTON DC
20016-4623
US

V. Phone/Fax

Practice location:
  • Phone: 202-351-9757
  • Fax: 202-673-3433
Mailing address:
  • Phone: 202-351-9757
  • Fax: 202-673-3433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD039915
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberMD039915
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD039915
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: