Basic Information
| Provider Information | |||||||||
| NPI: | 1669901740 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARIANI | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 FIELDSTONE DR | ||||||||
| Address2: | |||||||||
| City: | SHREWSBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015455042 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 640 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551012502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512540043 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2017 | ||||||||
| LastUpdateDate: | 07/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 71186 | MN | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 271758 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.