Individual
CHRISTOPHER WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 JOAN ST, RONKONKOMA, NY 11779-6213
(631) 428-0637
Mailing address
400 JOAN ST, RONKONKOMA, NY 11779-6213
(631) 428-0637
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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