Provider Demographics
NPI:1942367073
Name:EVANS, CHRIS H (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:H
Last Name:EVANS
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 GLEN EDYTH DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1706
Mailing Address - Country:US
Mailing Address - Phone:585-671-9925
Mailing Address - Fax:
Practice Address - Street 1:1096 GLEN EDYTH DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1706
Practice Address - Country:US
Practice Address - Phone:585-671-9925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2009-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000141-1231H00000X
NY14000004028237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY104531AIOtherPREFERRED CARE
NY7433490OtherATENA
NYP010000141OtherBCBS
NY000918334001OtherBCBS WNY
NYP010000141OtherBCBS