Provider Demographics
NPI:1710022454
Name:HEON, CHRISTOPHER NEIL (ATC, BOCO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:NEIL
Last Name:HEON
Suffix:
Gender:M
Credentials:ATC, BOCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 FRANK ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-3312
Mailing Address - Country:US
Mailing Address - Phone:203-927-3133
Mailing Address - Fax:
Practice Address - Street 1:282 STATE ST
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-2191
Practice Address - Country:US
Practice Address - Phone:877-470-8714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0002062255A2300X
222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer