Basic Information
Provider Information
NPI: 1225027071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRAMMAR
FirstName: CHRISTOPHER
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2005
Address2:  
City: EAST SYRACUSE
State: NY
PostalCode: 130574505
CountryCode: US
TelephoneNumber: 3154490513
FaxNumber: 3154452936
Practice Location
Address1: 1555 LONG POND RD
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146264122
CountryCode: US
TelephoneNumber: 5852558966
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/14/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X194747NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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