Provider Demographics
NPI:1275546467
Name:JUSTINICH, CHRISTOPHER JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:JUSTINICH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:251 SALINA MEADOWS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4516
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:725 IRVING AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-8444
Practice Address - Fax:315-464-8445
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-04-21
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Provider Licenses
StateLicense IDTaxonomies
AZ524122080P0206X
NY2384392080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02077838Medicaid
NY02077838Medicaid
NYJ400010851Medicare PIN