Provider Demographics
NPI:1477690378
Name:UDINA, CHRISTOPHER PAUL (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:UDINA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03216-0032
Mailing Address - Country:US
Mailing Address - Phone:603-735-6060
Mailing Address - Fax:877-521-6764
Practice Address - Street 1:8 N STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4038
Practice Address - Country:US
Practice Address - Phone:603-225-2512
Practice Address - Fax:603-225-3249
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0750152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30353247Medicaid
NH30353247Medicaid
NHRE7424Medicare ID - Type Unspecified