Healthcare Provider Details

I. General information

NPI: 1649254236
Provider Name (Legal Business Name): ALLEN CHINITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VALLEY HEALTH PLZ LUCKOW PAVILION
PARAMUS NJ
07652-3628
US

IV. Provider business mailing address

1 VALLEY HEALTH PLZ LUCKOW PAVILION
PARAMUS NJ
07652-3628
US

V. Phone/Fax

Practice location:
  • Phone: 201-634-5600
  • Fax: 201-634-5601
Mailing address:
  • Phone: 201-634-5600
  • Fax: 201-634-5601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MA02427900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: