Healthcare Provider Details
I. General information
NPI: 1346253218
Provider Name (Legal Business Name): CHATHAM PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2006
Last Update Date: 09/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 SHERMAN POTTS DR STE 203
GHENT NY
12075-3216
US
IV. Provider business mailing address
2 SHERMAN POTTS DR STE 203
GHENT NY
12075-3216
US
V. Phone/Fax
- Phone: 518-392-2277
- Fax: 518-392-7883
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VALERIE
S.
CURRY
Title or Position: OWNER
Credential: MD
Phone: 518-392-2277