Provider Demographics
NPI:1124154430
Name:O'CONNOR, CHRISTOPHER THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:O'CONNOR
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 1:1274 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7450
Mailing Address - Country:US
Mailing Address - Phone:718-370-0074
Mailing Address - Fax:718-370-0084
Practice Address - Street 1:1274 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-7450
Practice Address - Country:US
Practice Address - Phone:646-662-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX10462111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02882039Medicaid
NY662954OtherACN GROUP
NY5897528OtherGHI
NY837410OtherMPN
NY884228OtherHEALTHNET
NYOCO462OtherATLANTIS
NYP3175411OtherOXFORD
NY1048657OtherASHN
NYC10462-2 BOtherWORKERS COMPENSATION BOAR
NYP-12039392OtherMULTIPLAN
NY1048657OtherCIGNA
NY11303OtherMAGNACARE
NY837410OtherMPN
NYOCO462OtherATLANTIS