Healthcare Provider Details

I. General information

NPI: 1295723203
Provider Name (Legal Business Name): ANTOINE E CHIHA D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANTOINE E CHIHA DDS.PC

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 FORT HAMILTON PKWY
BROOKLYN NY
11209-4806
US

IV. Provider business mailing address

8440 FORT HAMILTON PKWY
BROOKLYN NY
11209-4806
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-5789
  • Fax: 718-745-1818
Mailing address:
  • Phone: 718-833-5789
  • Fax: 718-745-1818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDIO18475
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number044026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: