Provider Demographics
NPI:1962685073
Name:CHRISTENSEN, SEAN RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:RYAN
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 208059
Mailing Address - Street 2:333 CEDAR ST
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8059
Mailing Address - Country:US
Mailing Address - Phone:203-785-4632
Mailing Address - Fax:203-785-7637
Practice Address - Street 1:40 TEMPLE ST
Practice Address - Street 2:SUITE 5A
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2715
Practice Address - Country:US
Practice Address - Phone:203-785-3466
Practice Address - Fax:203-785-5256
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2014-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT050079207N00000X
CT50079207ND0101X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology