1255488342 NPI number — DR. CHRISTOPHER M PAWLINGA M.D.

Table of content: DR. CHRISTOPHER M PAWLINGA M.D. (NPI 1255488342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255488342 NPI number — DR. CHRISTOPHER M PAWLINGA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAWLINGA
Provider First Name:
CHRISTOPHER
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1255488342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1667 ELIZABETH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHENECTADY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12303-3805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-356-5377
Provider Business Mailing Address Fax Number:
518-881-1489

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1667 ELIZABETH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12303-3805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-356-5377
Provider Business Practice Location Address Fax Number:
518-881-1489
Provider Enumeration Date:
01/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  236500 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02685990 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 131001000109 . This is a "FIDELIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7372689 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 702232 . This is a "GHI/HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7348A1 . This is a "EMPIRE BLUECROSS BLUESHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com