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General NPI Number Information
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NPI Number | 1023227147
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Entity Type | Organization
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Legal Business Name | S.RICHARD CHAZIN MD.PC.
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24 KELLOGG RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-2800
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Country | US
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Telephone | 315-732-8616
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Fax | 315-793-0712
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Provider Business Mailing Address
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Address Line | 24 KELLOGG RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-2800
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Country | US
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Telephone | 315-732-8616
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Fax | 315-793-0712
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. S RICHARD CHAZIN
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Credential | MD
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Telephone | 315-732-8616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 102952
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License Number State | NY
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