Provider Demographics
NPI:1790135366
Name:DUFFY, CHRISTOPHER JAY
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAY
Last Name:DUFFY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S NORWINDEN DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3220
Mailing Address - Country:US
Mailing Address - Phone:610-357-8163
Mailing Address - Fax:
Practice Address - Street 1:313 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-1034
Practice Address - Country:US
Practice Address - Phone:800-906-7798
Practice Address - Fax:877-381-3806
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist