Healthcare Provider Details

I. General information

NPI: 1083585475
Provider Name (Legal Business Name): MR. CHRISTOPHER INFANTE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 AMELIA ST
RICHMOND VA
23220-6630
US

IV. Provider business mailing address

1821 AMELIA ST
RICHMOND VA
23220-6630
US

V. Phone/Fax

Practice location:
  • Phone: 804-780-6275
  • Fax:
Mailing address:
  • Phone: 804-780-6275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPPS0609120
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: