Provider Demographics
NPI:1902005093
Name:ANNESE, CHRISTIAN P (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:P
Last Name:ANNESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:401 SYLVAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2602
Mailing Address - Country:US
Mailing Address - Phone:201-541-5401
Mailing Address - Fax:201-816-1724
Practice Address - Street 1:69 ORIENT WAY
Practice Address - Street 2:MEDICAL IMAGING, P.A.
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2011
Practice Address - Country:US
Practice Address - Phone:201-933-5666
Practice Address - Fax:201-933-5662
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2317542085R0202X
VA01012440122085R0202X
NJ25MA085946002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology