Provider Demographics
NPI:1609971696
Name:KOCHIS, CHRISTOPHER JOHN (APRN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:KOCHIS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 FARMINGTON AVE
Mailing Address - Street 2:SUITE 123
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2162
Mailing Address - Country:US
Mailing Address - Phone:860-989-5055
Mailing Address - Fax:860-586-8976
Practice Address - Street 1:998 FARMINGTON AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2162
Practice Address - Country:US
Practice Address - Phone:860-989-5055
Practice Address - Fax:860-586-8976
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002412364SP0809X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT002412OtherAPRN LICENSE
CT002412OtherAPRN LICENSE