Provider Demographics
NPI:1730168287
Name:KALINYAK, CHRISTOPHER M (APRN, PMHNP-BC, DNP)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:KALINYAK
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 ELLERSTON WAY UNIT 821
Mailing Address - Street 2:
Mailing Address - City:AVE MARIA
Mailing Address - State:FL
Mailing Address - Zip Code:34142-5184
Mailing Address - Country:US
Mailing Address - Phone:330-554-4122
Mailing Address - Fax:
Practice Address - Street 1:6 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1237
Practice Address - Country:US
Practice Address - Phone:401-874-2246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02379363LP0808X
OHNP07646363LP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2888148Medicaid
OHMK0714786OtherDEA NUMBER
OHKANP19751Medicare PIN