Provider Demographics
NPI:1700948973
Name:MASSARI, CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:MASSARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:PINEDA-MASSARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:110 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2598
Mailing Address - Country:US
Mailing Address - Phone:315-349-5511
Mailing Address - Fax:315-349-5785
Practice Address - Street 1:110 W 6TH ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2598
Practice Address - Country:US
Practice Address - Phone:315-349-5511
Practice Address - Fax:315-349-5785
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD28579207R00000X, 208M00000X
NY336551207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR279366Medicaid
ORP01284390OtherMEDICARE RAILROAD
OR279366Medicaid