Healthcare Provider Details
I. General information
NPI: 1699931600
Provider Name (Legal Business Name): JAVIER CHAPOCHNICK FRIEDMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/30/2008
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
111 E 210TH ST ROSENTHAL 'C' - 2ND FLOOR
BRONX NY
10467-2401
US
IV. Provider business mailing address
111 E 210TH ST ROSENTHAL 'C' - 2ND FLOOR
BRONX NY
10467-2401
US
V. Phone/Fax
- Phone: 718-920-8907
- Fax: 718-547-4773
- Phone: 718-920-8907
- Fax: 718-547-4773
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204F00000X |
| Taxonomy | Transplant Surgery Physician |
| License Number | 003279 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: