Individual
CHRISTOPHER JOHN MAGNIFICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PO BOX 617, BAYPORT, NY 11705-0617
(631) 987-8034
(631) 853-3498
Mailing address
1869 BRENTWOOD RD, BRENTWOOD CLINIC, BRENTWOOD, NY 11717-4625
(631) 987-8034
(631) 853-3498
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
217739
NY
Other
Enumeration date
07/27/2006
Last updated
05/02/2017
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