Healthcare Provider Details

I. General information

NPI: 1831194497
Provider Name (Legal Business Name): CHRISTOPHER JAMES PATITSAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 WARM SPRINGS AVE STE 303
HUNTINGDON PA
16652-2300
US

IV. Provider business mailing address

1227 WARM SPRINGS AVE STE 303
HUNTINGDON PA
16652-2300
US

V. Phone/Fax

Practice location:
  • Phone: 814-643-5660
  • Fax: 814-643-5667
Mailing address:
  • Phone: 814-643-5660
  • Fax: 814-643-5667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD041833L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: