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General NPI Number Information
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NPI Number | 1891304325
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER R. PAGE, M.D., PLLC
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Dates
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Enumeration Date | 07/30/2020
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 21 CHESTNUT AVE
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City | SETAUKET
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State | NY
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Zip | 11733-4009
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Country | US
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Telephone | 631-235-0866
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Fax |
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Provider Business Mailing Address
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Address Line | 21 CHESTNUT AVE
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City | SETAUKET
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State | NY
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Zip | 11733-4009
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Country | US
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Telephone | 631-235-0866
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | CHRISTOPHER PAGE
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Credential | MD
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Telephone | 631-235-0866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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