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General NPI Number Information
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NPI Number | 1447881735
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Entity Type | Individual
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Provider Name | JIHEE CHAE
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 60 WISHING LN
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City | HICKSVILLE
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State | NY
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Zip | 11801-6423
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Country | US
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Telephone | 718-517-0813
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Fax |
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Provider Business Mailing Address
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Address Line | 125 E BETHPAGE RD STE 5
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City | PLAINVIEW
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State | NY
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Zip | 11803-4228
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Country | US
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Telephone | 718-517-0813
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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 | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 1252247
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License Number State | NY
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