1376524868 NPI number — CHRISTOPHER S OTTIANO M.D.

Table of content: CHRISTOPHER S OTTIANO M.D. (NPI 1376524868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376524868 NPI number — CHRISTOPHER S OTTIANO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OTTIANO
Provider First Name:
CHRISTOPHER
Provider Middle Name:
S
Provider Name Prefix Text:
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:
1376524868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1526 ATWOOD AVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
JOHNSTON
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02919-3289
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-270-5395
Provider Business Mailing Address Fax Number:
401-270-7635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1526 ATWOOD AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
JOHNSTON
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02919-3289
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-270-5395
Provider Business Practice Location Address Fax Number:
401-270-7635
Provider Enumeration Date:
11/10/2005

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: 174400000X , with the licence number:  10215 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: 226505 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1700719 . This is a "UHC" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 406994 . This is a "TUFTS" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 7056858 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: AA53166 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 27754 . This is a "BCBSRI - BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 27668 . This is a "NHP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: CIGNA . This is a "PR6379283" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 407203 . This is a "BCBSRI - BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 7870190 . This is a "AETNA" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




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