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General NPI Number Information
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NPI Number | 1699755280
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Entity Type | Organization
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Legal Business Name | CHIRAG V VASA, MD P.C.
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 2575 34TH ST
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City | ASTORIA
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State | NY
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Zip | 11103-4901
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Country | US
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Telephone | 718-721-3400
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Fax | 718-721-3434
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Provider Business Mailing Address
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Address Line | 701 EVANS PARAMUS
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City | PARAMUS
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State | NY
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Zip | 07652
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Country | US
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Telephone | 718-441-3970
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Fax | 718-441-6291
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | CHIRAG V VASA
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Credential | MD
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Telephone | 718-721-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 218197
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License Number State | NY
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