MEDICARE: CHRISTOPHER COX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse	533432	NY

General Provider Information

NPI Number	:	1184160814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER COX

Provider Business Mailing Address
First Line	:	46 5TH AVE S
Second Line	:
City	:	HUNTINGTON STATION
State	:	NY
Zip	:	11746-2343
Country	:	US
Telephone Number	:	631-549-3261
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 5TH AVE S
Second Line	:
City	:	HUNTINGTON STATION
State	:	NY
Zip	:	11746-2343
Country	:	US
Telephone Number	:	631-549-3261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2017
Last Update Date	:	01/19/2017

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