Healthcare Provider Details

I. General information

NPI: 1871266064
Provider Name (Legal Business Name): CHRISTOPHER ANDERSON MSED.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 DELAWARE AVE STE 2
OLEAN NY
14760-2601
US

IV. Provider business mailing address

787 LIPPERT HOLLOW RD
ALLEGANY NY
14706-9715
US

V. Phone/Fax

Practice location:
  • Phone: 716-307-3055
  • Fax:
Mailing address:
  • Phone: 716-307-3055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005658-01
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: