MEDICARE: STEVEN L CHRISTENSEN

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	2085R0202X	Diagnostic Radiology Physician	158105	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1609067	OTHER		INDEPENDANT HEALTH
2	00025517407	OTHER		UNIVERA
3	1581057CR	OTHER	NY	WORKERS COMPENSATION
4	000510111013	OTHER		BLUE SHIELD OF WESTERN NY

General Provider Information

NPI Number	:	1811971971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN L CHRISTENSEN

Provider Business Mailing Address
First Line	:	100 COLLEGE PKWY
Second Line	:	SUITE 180
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6800
Country	:	US
Telephone Number	:	716-636-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 COLLEGE PKWY
Second Line	:	SUITE 180
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6800
Country	:	US
Telephone Number	:	716-636-1902
Fax Number	:

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	05/28/2008

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Directions to “ STEVEN L CHRISTENSEN ” Practice Location

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