Individual
DR. CHRISTOPHER DAVID PASSIDOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
213 HALLOCK RD, SUITE 3A, STONY BROOK, NY 11790-3000
(631) 689-3771
(631) 689-1131
Mailing address
152 SYCAMORE CIR, STONY BROOK, NY 11790-3161
(631) 941-0018
(631) 941-0018
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
213818
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01955848
—
NY
01
—
213818
NEW YORK STATE LICENSE
NY
Enumeration date
08/31/2006
Last updated
03/07/2023
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