Provider Demographics
NPI:1740492032
Name:SCHMIDT, CHRISTOPHER ALEXANDER (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALEXANDER
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6004
Mailing Address - Country:US
Mailing Address - Phone:516-799-5370
Mailing Address - Fax:516-541-6874
Practice Address - Street 1:4400 MERRICK RD
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6004
Practice Address - Country:US
Practice Address - Phone:516-799-5370
Practice Address - Fax:516-541-6874
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX05621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY818525OtherMPN
NY2167639OtherAUSHC
NYC07947-7OtherWORKERS COMPENSATION ID
NY2C3235OtherHEALTHNET
NY324292OtherACN
NY5803716OtherGHI
NY818525OtherMPN
NYX05621Medicare ID - Type Unspecified