Provider Demographics
NPI:1700877495
Name:COSENTINO-CHALFANT, CHRISTINE M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:COSENTINO-CHALFANT
Suffix:
Gender:F
Credentials:MD
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 72384
Mailing Address - Street 2:RADIOLOGY ASSOCIATES OF CANTON, INC.
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44192-0002
Mailing Address - Country:US
Mailing Address - Phone:888-686-1837
Mailing Address - Fax:330-686-5928
Practice Address - Street 1:2600 6TH ST SW
Practice Address - Street 2:RADIOLOGY ASSOCIATES OF CANTON, INC
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710-1702
Practice Address - Country:US
Practice Address - Phone:330-363-2842
Practice Address - Fax:330-580-5536
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 06 1377C2085B0100X, 2085R0202X
OH35 06 1377 C2085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00269168OtherRAILROAD MEDICARE
OH0883405Medicaid
OHF40736Medicare UPIN
OH4039075Medicare PIN