MEDICARE: DENIS CHAGNON M.D.

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	207Q00000X	Family Medicine Physician	116548	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	:	1831288216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENIS CHAGNON M.D.

Provider Business Mailing Address
First Line	:	1927 SARANAC AVE
Second Line	:	SUITE 100
City	:	LAKE PLACID
State	:	NY
Zip	:	12946-1112
Country	:	US
Telephone Number	:	518-523-7575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1927 SARANAC AVE
Second Line	:	SUITE 100
City	:	LAKE PLACID
State	:	NY
Zip	:	12946-1112
Country	:	US
Telephone Number	:	518-523-7575
Fax Number	:

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	05/02/2013

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