Provider Demographics
NPI:1457310948
Name:LOTT, CHRISTOPHER P (RPA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:P
Last Name:LOTT
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 GENESEE ST
Mailing Address - Street 2:SUITE#2
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2658
Mailing Address - Country:US
Mailing Address - Phone:315-363-4651
Mailing Address - Fax:315-363-2821
Practice Address - Street 1:357 GENESEE ST
Practice Address - Street 2:SUITE#2
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2658
Practice Address - Country:US
Practice Address - Phone:315-363-4651
Practice Address - Fax:315-363-2821
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011188363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03259345Medicaid
NY011188OtherNYS LICENSE
NY03259345Medicaid