Basic Information
Provider Information
NPI: 1124124904
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCALABRIN
FirstName: CHRISTOPHER
MiddleName: G
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 43 PALMER ST
Address2:  
City: CALAIS
State: ME
PostalCode: 046191305
CountryCode: US
TelephoneNumber: 2074548150
FaxNumber: 2074540256
Practice Location
Address1: 37 PALMER ST
Address2:  
City: CALAIS
State: ME
PostalCode: 046191305
CountryCode: US
TelephoneNumber: 2074548195
FaxNumber: 2074543840
Other Information
ProviderEnumerationDate: 09/16/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XR053512MEY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000X0434312303NHN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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