Provider Demographics
NPI:1386987279
Name:MEDICI, CHRISTOPHER
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MEDICI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 E 53RD ST
Mailing Address - Street 2:APT 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4831
Mailing Address - Country:US
Mailing Address - Phone:646-322-7320
Mailing Address - Fax:
Practice Address - Street 1:249 E 53RD ST
Practice Address - Street 2:APT 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4831
Practice Address - Country:US
Practice Address - Phone:646-322-7320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY662341163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse