Provider Demographics
NPI:1538405493
Name:JONDA, CHRISTOPHER FRANK (PA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:FRANK
Last Name:JONDA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 NILES CORTLAND RD NE STE 4
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1077
Mailing Address - Country:US
Mailing Address - Phone:330-856-2545
Mailing Address - Fax:330-856-2542
Practice Address - Street 1:1950 NILES CORTLAND RD NE STE 4
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1077
Practice Address - Country:US
Practice Address - Phone:330-856-2545
Practice Address - Fax:330-856-2542
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003641363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0078315Medicaid
OHH155290Medicare PIN