1326632241 NPI number — CHRISTOPHER J. ECHEVARRIA

Table of content: CHRISTOPHER J. ECHEVARRIA (NPI 1326632241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326632241 NPI number — CHRISTOPHER J. ECHEVARRIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ECHEVARRIA
Provider First Name:
CHRISTOPHER
Provider Middle Name:
J.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1326632241
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VISTAS DE MONTE SOL
Provider Second Line Business Mailing Address:
110 CALLE SATURNO C11
Provider Business Mailing Address City Name:
YAUCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00698
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-299-1359
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VISTAS DE MONTE SOL
Provider Second Line Business Practice Location Address:
110 CALLE SATURNO C 11
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-299-1359
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2021

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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