Provider Demographics
NPI:1356875785
Name:DIGIAMMARINO, CHRIS
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:DIGIAMMARINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119R FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5975
Mailing Address - Country:US
Mailing Address - Phone:978-531-1772
Mailing Address - Fax:978-531-0760
Practice Address - Street 1:4 LAWRENCE LN
Practice Address - Street 2:
Practice Address - City:KITTERY POINT
Practice Address - State:ME
Practice Address - Zip Code:03905-5104
Practice Address - Country:US
Practice Address - Phone:781-706-0296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3830225X00000X, 225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology