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General NPI Number Information
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NPI Number | 1174262984
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Entity Type | Individual
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Provider Name | KRYSTLE CHALICH JD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 121 CAROLINE ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-3338
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Country | US
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Telephone | 518-312-9899
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Fax |
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Provider Business Mailing Address
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Address Line | 121 CAROLINE ST. UNIT 2 SARIZEN
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-3338
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Country | US
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Telephone | 518-312-9899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | 906369002
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License Number State | NY
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