Provider Demographics
NPI:1942397518
Name:MAURISCHAT, CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MAURISCHAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 1470
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-7470
Mailing Address - Country:US
Mailing Address - Phone:516-562-6605
Mailing Address - Fax:
Practice Address - Street 1:100 PORT WASHINGTON BLVD.
Practice Address - Street 2:DEPT. OF EMERGENCY MEDICINE
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1353
Practice Address - Country:US
Practice Address - Phone:631-686-7654
Practice Address - Fax:631-686-7653
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240764207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2737S1Medicare PIN
NYI66254Medicare UPIN