Provider Demographics
NPI:1982703443
Name:WARING, CHRISTOPHER A (MPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:WARING
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3614
Mailing Address - Country:US
Mailing Address - Phone:315-786-0655
Mailing Address - Fax:315-786-7993
Practice Address - Street 1:316 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3614
Practice Address - Country:US
Practice Address - Phone:315-786-0655
Practice Address - Fax:315-786-7993
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD 000Medicare UPIN