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NPI Code Detail

MEDICARE: ROBERT MARK CHASUK MD

MEDICARE: ROBERT MARK CHASUK 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
1207Q00000XFamily Medicine Physician07595LA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2080070636OTHERLARAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1942202627
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT MARK CHASUK MD
Provider Business Mailing Address
First Line : 1180 NEWFIELD AVE
Second Line :
City : STAMFORD
State : CT
Zip : 06905-1409
Country : US
Telephone Number : 314-888-5233
Fax Number :
Provider Business Practice Location Address
First Line : 1180 NEWFIELD AVE
Second Line :
City : STAMFORD
State : CT
Zip : 06905-1409
Country : US
Telephone Number : 314-888-5233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 03/17/2023

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Directions to “ ROBERT MARK CHASUK MD” Practice Location

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