Provider Demographics
NPI:1073966537
Name:CHRISTMAS, ERIC (THERAPEUTIC SUPPORT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:CHRISTMAS
Suffix:
Gender:M
Credentials:THERAPEUTIC SUPPORT
Other - Prefix:MR
Other - First Name:ERIC
Other - Middle Name:
Other - Last Name:CHRISTMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1 PINE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-1664
Mailing Address - Country:US
Mailing Address - Phone:203-747-4058
Mailing Address - Fax:
Practice Address - Street 1:1 PINE ROCK RD
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-1664
Practice Address - Country:US
Practice Address - Phone:203-747-4058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist