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NPI Code Detail

MEDICARE: GREGORY JASON CHRISTIE PA-C

MEDICARE: GREGORY JASON CHRISTIE PA-C
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
1363A00000XPhysician Assistant305MA

General Provider Information

NPI Number : 1255323135
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY JASON CHRISTIE PA-C
Provider Business Mailing Address
First Line : 140 HAVERHILL ST
Second Line : SUITE 1
City : ANDOVER
State : MA
Zip : 01810-1504
Country : US
Telephone Number : 978-470-0707
Fax Number : 978-470-8973
Provider Business Practice Location Address
First Line : 140 HAVERHILL ST
Second Line : SUITE 1
City : ANDOVER
State : MA
Zip : 01810-1504
Country : US
Telephone Number : 978-470-0707
Fax Number : 978-470-8973
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 07/08/2007

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Directions to “ GREGORY JASON CHRISTIE PA-C” Practice Location

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