Provider Demographics
NPI:1396905154
Name:TRAHAN, F. CHRISTOPHER (OMD, LAC)
Entity type:Individual
Prefix:
First Name:F. CHRISTOPHER
Middle Name:
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 W 21ST ST
Mailing Address - Street 2:SUITE 910
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 W 21ST ST
Practice Address - Street 2:SUITE 910
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6908
Practice Address - Country:US
Practice Address - Phone:212-337-0511
Practice Address - Fax:212-337-8528
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000197-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist