Healthcare Provider Details

I. General information

NPI: 1568501328
Provider Name (Legal Business Name): CHRISTIAN SALVATORE RAYMOND MD PC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 MIDLAND AVENUE
GARFIELD NJ
07026
US

IV. Provider business mailing address

362 MIDLAND AVENUE
GARFIELD NJ
07026
US

V. Phone/Fax

Practice location:
  • Phone: 973-478-7262
  • Fax: 973-478-3333
Mailing address:
  • Phone: 973-478-7262
  • Fax: 973-478-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00235000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: