Provider Demographics
NPI:1568737856
Name:DR. CHRISTIAN S RAYMOND
Entity Type:Organization
Organization Name:DR. CHRISTIAN S RAYMOND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-478-7262
Mailing Address - Street 1:93 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2321
Mailing Address - Country:US
Mailing Address - Phone:973-478-7262
Mailing Address - Fax:973-478-3333
Practice Address - Street 1:362 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1736
Practice Address - Country:US
Practice Address - Phone:973-478-7262
Practice Address - Fax:973-478-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7098308Medicaid
NJU61819Medicare UPIN
NJ875340Medicare PIN