Provider Demographics
NPI:1245022276
Name:SCIACCHITANO, CHRISTOPHER MATHEW (CRPA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MATHEW
Last Name:SCIACCHITANO
Suffix:
Gender:M
Credentials:CRPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SEGATOGUE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11720-1232
Mailing Address - Country:US
Mailing Address - Phone:631-202-9358
Mailing Address - Fax:
Practice Address - Street 1:33 SEGATOGUE LN
Practice Address - Street 2:
Practice Address - City:SOUTH SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11720-1232
Practice Address - Country:US
Practice Address - Phone:631-202-9358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCRPA-6527175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist