Provider Demographics
NPI:1417112566
Name:YARAS, CHRISTOPHER JOHN (IDC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:YARAS
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS HARTFORD SSN-768
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09573-2424
Mailing Address - Country:US
Mailing Address - Phone:860-694-2161
Mailing Address - Fax:860-694-4326
Practice Address - Street 1:USS HARTFORD SSN-768
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09573-2424
Practice Address - Country:US
Practice Address - Phone:860-694-2161
Practice Address - Fax:860-694-4326
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman