Provider Demographics
NPI:1134112188
Name:ANDREOLI, CHRISTOPHER MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:ANDREOLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:133 BROOKLINE AVE
Mailing Address - Street 2:OPHTHALMOLOGY DEPT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3904
Mailing Address - Country:US
Mailing Address - Phone:617-421-1151
Mailing Address - Fax:617-421-8787
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:OPHTHALMOLOGY DEPT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-1151
Practice Address - Fax:617-421-8787
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2011-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA223660207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2107261Medicaid
MAA3871501Medicare PIN