MEDICARE: MS. DANA CHAIS MS,RD,CDE,CDN

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	133V00000X	Registered Dietitian	00118	NY
2	133VN1004X	Pediatric Nutrition Registered Dietitian	00118	NY

General Provider Information

NPI Number	:	1336247550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANA CHAIS MS,RD,CDE,CDN

Provider Business Mailing Address
First Line	:	1735 YORK AVE
Second Line	:	APT 18D
City	:	NEW YORK
State	:	NY
Zip	:	10128-6855
Country	:	US
Telephone Number	:	212-772-3346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 YORK AVE
Second Line	:	APT 18D
City	:	NEW YORK
State	:	NY
Zip	:	10128-6855
Country	:	US
Telephone Number	:	212-772-3346
Fax Number	:

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	12/17/2010

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