Healthcare Provider Details

I. General information

NPI: 1033771241
Provider Name (Legal Business Name): PHILIP CHEBAYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 LANSING ST STE 302
AUBURN NY
13021-1983
US

IV. Provider business mailing address

17 LANSING ST
AUBURN NY
13021-1983
US

V. Phone/Fax

Practice location:
  • Phone: 315-567-0540
  • Fax: 315-567-0334
Mailing address:
  • Phone: 315-255-7011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number341006
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: