Healthcare Provider Details

I. General information

NPI: 1205987351
Provider Name (Legal Business Name): CHRISTOPHER M SINCLAIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHRISTOPHER SINCLAIR MD

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/21/2022
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 WINDWARD DR
PORT JEFFERSON NY
11777-2322
US

IV. Provider business mailing address

254 WINDWARD DR
PORT JEFFERSON NY
11777-2322
US

V. Phone/Fax

Practice location:
  • Phone: 631-560-7290
  • Fax:
Mailing address:
  • Phone: 631-560-7290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301505450
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number232434
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number042228
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number232434
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: