Basic Information
| Provider Information | |||||||||
| NPI: | 1548318280 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHRISTOPHER R BRANCATO MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 175 | ||||||||
| Address2: | |||||||||
| City: | NORTHUMBERLAND | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178570175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5709880925 | ||||||||
| FaxNumber: | 5709880919 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 N 12TH ST STE B | ||||||||
| Address2: | |||||||||
| City: | SUNBURY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178011654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702869523 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 03/14/2012 | ||||||||
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| AuthorizedOfficialLastName: | BRANCATO | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5702689523 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 0014132390003 | 05 | PA | MEDICAID | CB5094 | 01 | PA | RAIL ROAD MEDICARE | OTHER |