Provider Demographics
NPI:1083885933
Name:CHRISTOPHER F. PAONESSA
Entity Type:Organization
Organization Name:CHRISTOPHER F. PAONESSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED ORTHOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:PAONESSA
Authorized Official - Suffix:
Authorized Official - Credentials:BOCO
Authorized Official - Phone:518-641-6318
Mailing Address - Street 1:319 SOUTH MANNING BLVD, SUITE 105
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-641-6318
Mailing Address - Fax:518-459-2928
Practice Address - Street 1:319 S MANNING BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1744
Practice Address - Country:US
Practice Address - Phone:518-641-6318
Practice Address - Fax:518-459-2928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5691200001Medicare NSC