Provider Demographics
NPI:1548318280
Name:CHRISTOPHER R BRANCATO MD PC
Entity type:Organization
Organization Name:CHRISTOPHER R BRANCATO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRANCATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-268-9523
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:NORTHUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17857-0175
Mailing Address - Country:US
Mailing Address - Phone:570-988-0925
Mailing Address - Fax:570-988-0919
Practice Address - Street 1:330 N 12TH ST STE B
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-1654
Practice Address - Country:US
Practice Address - Phone:570-286-9523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014132390003Medicaid
PACB5094OtherRAIL ROAD MEDICARE
PA177880Medicare PIN