Healthcare Provider Details

I. General information

NPI: 1386682193
Provider Name (Legal Business Name): CHRISTOPHER PATRICK PARISI CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PROSPECT AVE
SYRACUSE NY
13203-1807
US

IV. Provider business mailing address

102 WOODED HEIGHTS DR
CAMILLUS NY
13031-1928
US

V. Phone/Fax

Practice location:
  • Phone: 315-448-5440
  • Fax:
Mailing address:
  • Phone: 315-488-5103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number448463
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: