Provider Demographics
NPI:1831242791
Name:ROBERTO, CHRISTOPHER M (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:ROBERTO
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 1:633 ROUTE 211 E
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-1780
Mailing Address - Country:US
Mailing Address - Phone:845-692-3224
Mailing Address - Fax:
Practice Address - Street 1:633 ROUTE 211 E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1780
Practice Address - Country:US
Practice Address - Phone:845-692-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010822-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX6X571Medicare ID - Type Unspecified
NYU99083Medicare UPIN