Provider Demographics
NPI:1023668209
Name:CAISSIE, CHRISTOPHER D (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:D
Last Name:CAISSIE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:535 CENTERVILLE ROAD
Mailing Address - Street 2:STE 102
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886
Mailing Address - Country:US
Mailing Address - Phone:401-773-7220
Mailing Address - Fax:401-773-7221
Practice Address - Street 1:535 CENTERVILLE ROAD
Practice Address - Street 2:STE 102
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-773-7220
Practice Address - Fax:401-773-7221
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA60988363A00000X
MAPA7237363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant