=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063450062
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ESTHER CHAIM DO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2006
-----------------------------------------------------
Last Update Date | 10/08/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10910 QUEENS BLVD
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-5371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-459-1111
-----------------------------------------------------
Fax | 718-459-1033
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10910 QUEENS BLVD
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-5371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-459-1111
-----------------------------------------------------
Fax | 718-459-1033
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 229231
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------