MEDICARE: DR. ANTOINE E CHIHA D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	DIO18475	NJ
2	1223P0700X	Prosthodontics	044026	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295723203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTOINE E CHIHA D.D.S

Provider Business Mailing Address
First Line	:	8440 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4806
Country	:	US
Telephone Number	:	718-833-5789
Fax Number	:	718-745-1818

Provider Business Practice Location Address
First Line	:	8440 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4806
Country	:	US
Telephone Number	:	718-833-5789
Fax Number	:	718-745-1818

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	11/06/2017

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