Provider Demographics
NPI:1992001762
Name:STAPLES, CHRISTOPHER ELLIOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ELLIOTT
Last Name:STAPLES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:NJ
Mailing Address - Zip Code:07823-2010
Mailing Address - Country:US
Mailing Address - Phone:484-903-3779
Mailing Address - Fax:
Practice Address - Street 1:40 PITTSTOWN RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1209
Practice Address - Country:US
Practice Address - Phone:908-735-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00499900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical