Basic Information
Provider Information
NPI: 1699095026
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VARGO
FirstName: CHRISTOPHER
MiddleName: PAUL
NamePrefix: MR.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 680 BLAIR MILL RD
Address2:  
City: HORSHAM
State: PA
PostalCode: 190442223
CountryCode: US
TelephoneNumber: 7174461220
FaxNumber: 8888168109
Practice Location
Address1: 770 POPLAR CHURCH RD
Address2:  
City: CAMP HILL
State: PA
PostalCode: 170112302
CountryCode: US
TelephoneNumber: 7174461220
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/08/2010
LastUpdateDate: 07/18/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XSP010811PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


Home