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General NPI Number Information
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NPI Number | 1659426948
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER D. JUSTOFIN,D.O.,P.C.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 106 ROTARY DR
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City | W HAZLETON
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State | PA
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Zip | 18202-1182
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Country | US
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Telephone | 570-455-2286
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Fax | 570-455-2336
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Provider Business Mailing Address
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Address Line | 106 ROTARY DR
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City | W HAZLETON
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State | PA
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Zip | 18202-1182
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Country | US
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Telephone | 570-455-2286
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KELLY O JUSTOFIN
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Credential |
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Telephone | 570-455-2286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS008405L
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License Number State | PA
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