MEDICARE: DR. LEONARD A CHIAT D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	028581	NY

General Provider Information

NPI Number	:	1760486799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD A CHIAT D.D.S

Provider Business Mailing Address
First Line	:	978 ROUTE 45
Second Line	:	STE 104
City	:	POMONA
State	:	NY
Zip	:	10970-3565
Country	:	US
Telephone Number	:	845-362-0770
Fax Number	:	845-362-7406

Provider Business Practice Location Address
First Line	:	978 ROUTE 45
Second Line	:	STE 104
City	:	POMONA
State	:	NY
Zip	:	10970-3565
Country	:	US
Telephone Number	:	845-362-0770
Fax Number	:	845-362-7406

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. LEONARD A CHIAT D.D.S” Practice Location

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