Provider Demographics
NPI:1831185123
Name:JEFFRIES, CHRISTIE L (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:L
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-798-8012
Practice Address - Street 1:728 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5200
Practice Address - Country:US
Practice Address - Phone:203-291-3800
Practice Address - Fax:203-226-1204
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT041087207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H99791Medicare UPIN