Provider Demographics
NPI:1194759068
Name:DEMASI, CHRISTOPHER L (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:L
Last Name:DEMASI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:908-232-1439
Practice Address - Street 1:202 ELMER ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2128
Practice Address - Country:US
Practice Address - Phone:908-228-3675
Practice Address - Fax:908-654-1053
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07435900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00850161OtherMEDICARE RR PTAN
NJ0052019Medicaid
NJ071953YAK2Medicare PIN
H90935Medicare UPIN
NJP00850161OtherMEDICARE RR PTAN