Basic Information
| Provider Information | |||||||||
| NPI: | 1881861433 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEDERICO | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | HUGHES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 LAUREL RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080438303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566696050 | ||||||||
| FaxNumber: | 8565283117 | ||||||||
| Practice Location | |||||||||
| Address1: | 731 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | BAYONNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070024783 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737361100 | ||||||||
| FaxNumber: | 9737361134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2008 | ||||||||
| LastUpdateDate: | 02/18/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 45468 | KY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 25MA10761600 | NJ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 298941 | 01 | NY | STATE LICENSE | OTHER | 7100209340 | 05 | KY | MEDICAID |