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General NPI Number Information
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NPI Number | 1194354738
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Entity Type | Individual
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Provider Name | CHAYA FELLIG PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 04/06/2020
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Provider Practice Location Address
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Address Line | 550 SW 3RD ST STE 305
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6946
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Country | US
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Telephone | 954-941-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 5 ISLAND AVE APT 4H
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1322
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Country | US
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Telephone | 786-543-5966
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9112581
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License Number State | FL
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