Provider Demographics
NPI:1548457229
Name:JANOWIECKI, CHRISTOPHER ROBERT (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:JANOWIECKI
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 1:1 HOSPITAL PLZ
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3602
Mailing Address - Country:US
Mailing Address - Phone:203-276-7298
Mailing Address - Fax:203-276-4842
Practice Address - Street 1:1 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3602
Practice Address - Country:US
Practice Address - Phone:203-276-7298
Practice Address - Fax:203-276-4842
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT66744208M00000X, 207R00000X
KY43622208M00000X, 207R00000X
TN47115208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN01445185OtherAMERIGROUP
KY7100134590Medicaid
TN1524371Medicaid
TN4354402OtherBLUE CROSS-BLUE SHIELD
TN4299677OtherBCBST
TNP01000933OtherRR MEDICARE
KY7100134590Medicaid
TN10311I4927Medicare PIN