MEDICARE: DR. HERBERT STANLEY CHASE JR. MD

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	207RN0300X	Nephrology Physician	124031	NY

General Provider Information

NPI Number	:	1922082791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT STANLEY CHASE JR. MD

Provider Business Mailing Address
First Line	:	227 CENTRAL PARK W APT 3B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-6058
Country	:	US
Telephone Number	:	917-225-6937
Fax Number	:	212-595-2371

Provider Business Practice Location Address
First Line	:	227 CENTRAL PARK W APT 3B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-6058
Country	:	US
Telephone Number	:	917-225-6937
Fax Number	:	212-595-2371

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	05/18/2019

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