Provider Demographics
NPI:1477627727
Name:ADSIT, CHRISTOPHER L (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:ADSIT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1073 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3129
Mailing Address - Country:US
Mailing Address - Phone:814-333-6606
Mailing Address - Fax:814-333-6616
Practice Address - Street 1:1073 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3129
Practice Address - Country:US
Practice Address - Phone:814-333-6606
Practice Address - Fax:814-333-6616
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000417152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015356070002Medicaid
PA07769OtherVISION BENEFITS OF AMERIC
396652OtherNATIONAL VISION ADMINISTR
U56796Medicare UPIN
PA07769OtherVISION BENEFITS OF AMERIC
PA0015356070002Medicaid