Basic Information
Provider Information
NPI: 1598756033
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAMMARATA
FirstName: CHRISTOPHER
MiddleName: REED
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 333 STATE ST STE 103
Address2:  
City: ERIE
State: PA
PostalCode: 165071450
CountryCode: US
TelephoneNumber: 8148777157
FaxNumber: 8148772844
Practice Location
Address1: 201 STATE ST
Address2:  
City: ERIE
State: PA
PostalCode: 165509762
CountryCode: US
TelephoneNumber: 8148776139
FaxNumber: 8148776093
Other Information
ProviderEnumerationDate: 11/03/2005
LastUpdateDate: 03/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XOS013459PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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