Individual
CHRISTOPHER PEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1149 LINCOLN AVE, LOCKPORT, NY 14094-6152
(716) 433-2674
Mailing address
1149 LINCOLN AVE, LOCKPORT, NY 14094-6152
(716) 433-2674
(716) 433-2677
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010083-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570494002
BLUE SHIELD
NY
Enumeration date
07/11/2006
Last updated
12/02/2024
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