Provider Demographics
NPI:1891304325
Name:CHRISTOPHER R. PAGE, M.D., PLLC
Entity Type:Organization
Organization Name:CHRISTOPHER R. PAGE, M.D., PLLC
Other - Org Name:LOTUS INTEGRATIVE HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-235-0866
Mailing Address - Street 1:21 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-4009
Mailing Address - Country:US
Mailing Address - Phone:631-235-0866
Mailing Address - Fax:
Practice Address - Street 1:21 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4009
Practice Address - Country:US
Practice Address - Phone:631-235-0866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty