CHRISTOPHER DEMTRAK (NPI# 1629078928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629078928 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER DEMTRAK |
| Credential | MD |
| Practice Address |
601 Riverside Dr Johnson City NY 13790-2544 |
| Mailing Address |
346 Grand Ave United Medical Associates PC Johnson City NY 13790-2558 |
| Practice Telephone | 6077294393 |
| Practice Fax Number | 6077293982 |
| Mailing Telephone | 6077636293 |
| Mailing Fax Number | 6077636717 |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2009-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 094998 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00553264 | 05 |
| Street Address |
601 RIVERSIDE DR |
| City | JOHNSON CITY |
| State | NY |
| Zip Code | 13790-2544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033110424 | Galen Graham | Internal Medicine | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2005-08-09 |
| 1366837569 | Professional Home Care | Home Health | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2015-04-03 |
| 1336413517 | Project Hear, Inc | Emergency Response System Companies | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2012-03-06 |
| 1700057742 | William G Waldron | Pharmacist | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2008-03-18 |
| 1366626434 | Joyce M Smith | Pharmacist | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2007-12-24 |
| 1639292741 | Preeti Jhaveri | Obstetrics & Gynecology | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2007-04-06 |
| 1205873387 | Tamara Burger | Advanced Practice Midwife | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2006-05-31 |
| 1821089517 | Donna Lee Gardner | Nurse Practitioner | 601 Riverside Dr, United Medical Associates PC, Johnson City, NY 13790-2544 | 2005-11-02 |
| 1982699252 | Professional Home Care Inc | Durable Medical Equipment & Medical Supplies | 601 Riverside Dr, Johnson City, NY 13790-2544 | 2005-09-13 |
| 1841284387 | Edward D Miller | Internal Medicine | 601 Riverside Dr, United Medical Associates PC, Johnson City, NY 13790-2544 | 2005-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578107645 | Thomas William Sorber | Occupational Therapist | 33 Harrison St, Johnson City, Johnson City, NY 13790 | 2019-11-01 |
| 1326534116 | Silver Linings Golden Memory Care | Clinic/Center | 4416 Watson Blvd, Johnson City, NY 13790 | 2018-07-05 |
| 1508308545 | Irene Mukeli Nzasi | Registered Nurse | 156 Corliss Ave Suite 107, Johnson City, NY 13790 | 2016-11-08 |
| 1053867754 | Tabitha Rae Toman | Physical Therapist | 34 Harrison St, Johnson City, NY 13790 | 2016-09-01 |
| 1235685066 | Dianne Brunner | Physical Therapist | 33-55 Harrison Street, Wilson Hospital, Johnson City, NY 13790 | 2016-08-31 |
| 1578982682 | Tracy Lynn Brown | Optometrist | 223 Reynolds Road, Johnson City, NY 13790 | 2014-04-16 |
| 1083041495 | Maryann Serbonich | Pharmacist | 52 Harrison Street, Johnson City, NY 13790 | 2013-09-30 |
| 1134464399 | Kasey Connor Folger | Speech-Language Pathologist | 3 Laurel St., Johnson City, NY 13790 | 2012-11-29 |
| 1467797571 | Bodyworks Physical Therapy LLC | Clinic/Center | 765 Harry L Drive, Johnson City, NY 13790 | 2012-11-29 |
| 1548518400 | Melissa L Korosec | Nurse Practitioner | 30 Harrison St., Suite 250, Johnson City, NY 13790 | 2012-08-27 |
| Find all providers in zip 13790 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922453190 | Rachel Michelle Lindsey | Pediatrics | 325 N State of Franklin Rd, Ground Floor, Etsu Physicians and Associates Pediatrics, Johnson City, TN 37604-6056 | 2016-04-25 |
| 1609261197 | Lauren Nichols Swift | Pediatrics | 325 N. State of Franklin Road, Ground Floor, Johnson City, TN 37604 | 2015-04-01 |
| 1437579760 | Daniel P Armentrout | Pediatrics | 301 Med Tech Pkwy Ste 160, Johnson City, TN 37604 | 2014-04-25 |
| 1225309891 | Medical Education Assistance Corporation | Pediatrics | 201 E Myrtle Ave, Johnson City, TN 37601 | 2012-01-13 |
| 1558673434 | Himabindu Kasivajjula | Pediatrics | 639 Main Street, Johnson City, NY 13790 | 2010-07-08 |
| 1558428037 | Beth W Hapke | Pediatrics | 512 Reynolds Rd, Apt K12, Johnson City, NY 13790-1366 | 2007-01-03 |
| 1750461265 | Shasta B Helsel | Pediatrics | 301 Med Tech Pkwy Ste 180, Johnson City, TN 37604 | 2006-10-17 |
| 1497738041 | Samuel Boi Addo | Pediatrics | 269 Riverside Dr, Johnson City, NY 13790-2726 | 2005-11-28 |
| 1831184266 | Otto H.p. Teixeira | Pediatrics | 325 N State of Franklin Rd., Ground Floor, Johnson City, TN 37604-6062 | 2005-09-12 |
| 1083619118 | Jodi B Gage | Pediatrics | 325 N. State of Franklin Road, Ground Floor, Johnson City, TN 37604 | 2005-06-16 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 13790 |
Please comment or provide details below to improve the information on CHRISTOPHER DEMTRAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.