Provider Demographics
NPI:1891930897
Name:SCIANNA, CHRISTOPHER ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:SCIANNA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:750 EAST ADAMS STREET
Mailing Address - Street 2:SUNY UPSTATE MEDICAL UNIVERSITY
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2375
Mailing Address - Country:US
Mailing Address - Phone:315-464-4363
Mailing Address - Fax:315-464-4854
Practice Address - Street 1:750 EAST ADAMS STREET
Practice Address - Street 2:SUNY UPSTATE MEDICAL UNIVERSITY
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2375
Practice Address - Country:US
Practice Address - Phone:315-464-4363
Practice Address - Fax:315-464-4854
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252894-1207P00000X
PAOS022512207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400029807Medicare PIN
NYJ400019369Medicare PIN