| Doctor Name: | MR. CHRISTOPHER J FIDELI |
| NPI Number: | 1023295649 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 003006 |
| Business Practice Address: | 2 Shadetree Ln Stony Brook, NY - 117903115 |
| Business Phone Number: | 5168184435 |
| Business Fax Number: | |
| Mailing Address: | 2 Shadetree Ln, STONY BROOK |
| State: | NY |
| Postal Code: | 117903115 |
| Phone Number: | 5168184435 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2008 |
| NPI Last Update Date: | 01/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | 003006 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |