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General NPI Number Information
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NPI Number | 1598941601
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER M. DEAKIN, M.D. PLLC
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 01/18/2008
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Provider Practice Location Address
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Address Line | 4140 SHERIDAN DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4341
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Country | US
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Telephone | 716-634-1360
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Fax |
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Provider Business Mailing Address
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Address Line | 4140 SHERIDAN DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4341
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Country | US
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Telephone | 716-634-1360
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER DEAKIN
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Credential | M.D.
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Telephone | 716-634-1360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 223952
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License Number State | NY
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