Provider Demographics
NPI:1669473807
Name:DUBY, CHRISTOPHER P (PA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:P
Last Name:DUBY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:230 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2917
Mailing Address - Country:US
Mailing Address - Phone:914-684-6113
Mailing Address - Fax:914-684-2740
Practice Address - Street 1:2900 WESTCHESTER AVE
Practice Address - Street 2:STE 307
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2551
Practice Address - Country:US
Practice Address - Phone:914-249-7000
Practice Address - Fax:914-249-7032
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009014363A00000X
CT001290363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP77824Medicare UPIN
NY5F6962Medicare PIN