Provider Demographics
NPI:1447485792
Name:PICCOLO, CHRISTIAN (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:PICCOLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 COMMERCE STREET
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-4428
Mailing Address - Country:US
Mailing Address - Phone:914-245-3060
Mailing Address - Fax:914-245-3065
Practice Address - Street 1:1940 COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10589-4428
Practice Address - Country:US
Practice Address - Phone:914-245-3060
Practice Address - Fax:914-245-3065
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-15
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244335207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine