Provider Demographics
NPI:1295774032
Name:EVANS, CHRISTOPHER J (RPA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:EVANS
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-8626
Mailing Address - Country:US
Mailing Address - Phone:518-581-1100
Mailing Address - Fax:518-581-0233
Practice Address - Street 1:381 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-8626
Practice Address - Country:US
Practice Address - Phone:518-581-1100
Practice Address - Fax:518-581-0233
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008633363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000411774001OtherBLUE SHIELD NENY
NYP00369749Medicare PIN
NYQ40566Medicare UPIN