1548318280 NPI number — CHRISTOPHER R BRANCATO MD PC

Table of content: (NPI 1548318280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548318280 NPI number — CHRISTOPHER R BRANCATO MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTOPHER R BRANCATO MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548318280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 175
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHUMBERLAND
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17857-0175
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-988-0925
Provider Business Mailing Address Fax Number:
570-988-0919

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 N 12TH ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNBURY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17801-1654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-286-9523
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BRANCATO
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
570-268-9523

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0014132390003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CB5094 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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