Provider Demographics
NPI:1942399274
Name:MAIN, CHRISTOPHER I (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:I
Last Name:MAIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-2707
Mailing Address - Country:US
Mailing Address - Phone:315-759-5343
Mailing Address - Fax:
Practice Address - Street 1:809 CANANDAIGUA RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-2003
Practice Address - Country:US
Practice Address - Phone:315-781-1162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4578152W00000X
NY007303152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist