Individual
DR. CHRISTOPHER PAUL ANTIPAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1350 ROUTE 112, PORT JEFFERSON STATION, NY 11776-3078
(631) 745-9005
Mailing address
1 LILAC DR, STONY BROOK, NY 11790-1416
(631) 689-2560
(631) 246-6299
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
010539-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01651165
—
NY
Enumeration date
06/22/2006
Last updated
08/02/2010
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