Provider Demographics
NPI:1750414348
Name:CHRISTAKOS, ROBERT C (PT, DPT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:CHRISTAKOS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 PARRISH STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1784
Mailing Address - Country:US
Mailing Address - Phone:585-396-1400
Mailing Address - Fax:585-396-3368
Practice Address - Street 1:241 PARRISH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1784
Practice Address - Country:US
Practice Address - Phone:585-396-1400
Practice Address - Fax:585-396-3368
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034696225100000X
CA0PT266980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT266980Medicare ID - Type Unspecified