Provider Demographics
NPI:1558637454
Name:ATALLA, CHRISTOPHER SEFEIN (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SEFEIN
Last Name:ATALLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:332 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8436
Mailing Address - Country:US
Mailing Address - Phone:631-665-3737
Mailing Address - Fax:631-665-3744
Practice Address - Street 1:332 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8436
Practice Address - Country:US
Practice Address - Phone:631-665-3737
Practice Address - Fax:631-665-3744
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN61625208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology