Provider Demographics
NPI:1205285582
Name:LOVELL, CHRISTOPHER (DPM)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:LOVELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 E 91ST ST
Mailing Address - Street 2:APT 17
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5348
Mailing Address - Country:US
Mailing Address - Phone:715-212-8414
Mailing Address - Fax:
Practice Address - Street 1:2409 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5324
Practice Address - Country:US
Practice Address - Phone:203-334-6955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006790213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery