Provider Demographics
NPI:1417901778
Name:KERSZKO, CHRISTOPHER J (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:KERSZKO
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:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891
Mailing Address - Country:US
Mailing Address - Phone:401-315-2225
Mailing Address - Fax:401-315-2224
Practice Address - Street 1:105 FRANKLIN ST
Practice Address - Street 2:SUITE 29
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-3149
Practice Address - Country:US
Practice Address - Phone:401-315-2225
Practice Address - Fax:401-315-2224
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDC00426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI359003426Medicare ID - Type Unspecified
U98546Medicare UPIN