MEDICARE: CHRISTOPHER M. DEAKIN, M.D. PLLC

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	261QM0850X	Adult Mental Health Clinic/Center	223952	NY

General Provider Information

NPI Number	:	1598941601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER M. DEAKIN, M.D. PLLC

Provider Business Mailing Address
First Line	:	4140 SHERIDAN DR
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-4341
Country	:	US
Telephone Number	:	716-634-1360
Fax Number	:

Provider Business Practice Location Address
First Line	:	4140 SHERIDAN DR
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-4341
Country	:	US
Telephone Number	:	716-634-1360
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER DEAKIN
Credential	:	M.D.
Telephone Number	:	716-634-1360

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	01/18/2008

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