Provider Demographics
NPI:1831194497
Name:PATITSAS, CHRISTOPHER JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:PATITSAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1227 WARM SPRINGS AVE
Mailing Address - Street 2:STE 303
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-2300
Mailing Address - Country:US
Mailing Address - Phone:814-643-5660
Mailing Address - Fax:814-643-5667
Practice Address - Street 1:1227 WARM SPRINGS AVE
Practice Address - Street 2:STE 303
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2300
Practice Address - Country:US
Practice Address - Phone:814-643-5660
Practice Address - Fax:814-643-5667
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041833L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA608474OtherBLUE SHIELD
PA1811466OtherBLUE SHIELD
PA251634705OtherTRICARE
PA251634705OtherTRICARE
PA1811466OtherBLUE SHIELD
PAPA00327371Medicare ID - Type UnspecifiedUNITED MINEWORKER MEDICAR
PAE65285Medicare UPIN