Provider Demographics
NPI:1154513976
Name:WISE, CHRISTOPHER SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:WISE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2354
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:2201 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1859
Practice Address - Country:US
Practice Address - Phone:516-572-0213
Practice Address - Fax:516-945-3131
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2014-11-10
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Provider Licenses
StateLicense IDTaxonomies
WY7797A207L00000X
NY27319207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology