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NPI 1992757454

NPI 1992757454 : ANDRE CHAPUT M.D. : WATERTOWN, NY

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General NPI Number Information
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    NPI Number           |    1992757454
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    Entity Type          |    Individual 
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    Provider Name        |    ANDRE CHAPUT M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/16/2006
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    Last Update Date     |    04/30/2008
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Provider Practice Location Address
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    Address Line         |    830 WASHINGTON ST 
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601-4066
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    Country              |    US
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    Telephone            |    315-785-4313
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    Fax                  |    315-779-5114
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Provider Business Mailing Address
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    Address Line         |    PO BOX 91 
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601-0091
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    Country              |    US
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    Telephone            |    315-782-4207
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    Fax                  |    315-782-8699
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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        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    185348
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    License Number State |    NY
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