Basic Information
Provider Information
NPI: 1922316371
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HALL
FirstName: CHRISTOPHER
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 801 OSTRUM ST
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180151000
CountryCode: US
TelephoneNumber: 4845266048
FaxNumber: 4845266500
Practice Location
Address1: 44 W 21ST ST
Address2: STE 101
City: NORTHAMPTON
State: PA
PostalCode: 180671221
CountryCode: US
TelephoneNumber: 6102610999
FaxNumber: 6102612187
Other Information
ProviderEnumerationDate: 09/20/2010
LastUpdateDate: 10/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA054690PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home