1679563985 NPI number — DR. STEVEN WEBSTER CHRISTIANSON D.O.

Table of content: DR. STEVEN WEBSTER CHRISTIANSON D.O. (NPI 1679563985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679563985 NPI number — DR. STEVEN WEBSTER CHRISTIANSON D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTIANSON
Provider First Name:
STEVEN
Provider Middle Name:
WEBSTER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
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:
1679563985
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
122 SAXON WOODS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10605-4813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-949-6113
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 PENN PLZ
Provider Second Line Business Practice Location Address:
12TH FLOOR, VNS CHOICE
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10001-1810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-609-5614
Provider Business Practice Location Address Fax Number:
212-290-4855
Provider Enumeration Date:
10/27/2005

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: 207R00000X , with the licence number:  179894-1 , 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)





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