Healthcare Provider Details

I. General information

NPI: 1457092959
Provider Name (Legal Business Name): DANIEL CHAIT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2621
US

IV. Provider business mailing address

2231 PEMBERTON ST
PHILADELPHIA PA
19146-1140
US

V. Phone/Fax

Practice location:
  • Phone: 440-454-3275
  • Fax:
Mailing address:
  • Phone: 440-454-3275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1023407
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: