Provider Demographics
NPI:1114682655
Name:FLICK, CHRISTOPHER J
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:FLICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DEEP LN
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1806
Mailing Address - Country:US
Mailing Address - Phone:516-647-0913
Mailing Address - Fax:
Practice Address - Street 1:275 MOUNT CARMEL AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1908
Practice Address - Country:US
Practice Address - Phone:516-647-0913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program