Christian D. Tvetenstrand MD, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

178438 Issued in NY

Legal business name

CHRISTIAN D. TVETENSTRAND MD, PLLC

Practice address

30 Harrison St
Suite 320
Johnson City, NY 13790-2161

Phone

(607) 763-8205

Fax

(607) 763-8208

NPI assigned

May 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christian Dahn Tvetenstrand, M.D.

Title

President

Phone

(607) 763-8205

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Southern Tier Surgical Clinic Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1679526669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST",
            "address_2": "SUITE 320",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902161",
            "telephone_number": "607-763-8205",
            "fax_number": "607-763-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST",
            "address_2": "SUITE 320",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902161",
            "telephone_number": "607-763-8205",
            "fax_number": "607-763-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN D. TVETENSTRAND MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "TVETENSTRAND",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "DAHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "607-763-8205",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "178438",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01135079",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Tier Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Chisdak, MD
• Myriam Chlela
• Sewng Choi, MD
• Ahmed Faisal Chowdhury, MD
• Ishraq Chowdhury, DO
• Mia Cicoria-Timm
• Amber Cina
• Katelyn Clarke, NURSE PRACTITIONER
• David J Clovsky, LCSW R
• Deborah Cohen, M.D.

• Specialist in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.