Provider Demographics
NPI:1316965007
Name:SCIALES, CHRISTOPHER W (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:W
Last Name:SCIALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:GREEN VILLAGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07935
Mailing Address - Country:US
Mailing Address - Phone:973-966-0908
Mailing Address - Fax:
Practice Address - Street 1:201 S LIVINGSTON AVE
Practice Address - Street 2:LIVINGSTON DERMATOLOGY
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4043
Practice Address - Country:US
Practice Address - Phone:973-994-1170
Practice Address - Fax:973-994-1170
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA053787207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223824190OtherTAX ID
NJ223824190OtherTAX ID
NJ676882P67Medicare ID - Type Unspecified