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NPI Code Detail

MEDICARE: DR. ALLEN CHICOTE OD

MEDICARE: DR. ALLEN CHICOTE OD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2152W00000XOptometrist009679NY

General Provider Information

NPI Number : 1972227825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLEN CHICOTE OD
Provider Business Mailing Address
First Line : 15211 89TH AVE APT 729
Second Line :
City : JAMAICA
State : NY
Zip : 11432-3788
Country : US
Telephone Number : 951-403-3843
Fax Number :
Provider Business Practice Location Address
First Line : 1258 6TH AVE FL 1
Second Line :
City : NEW YORK
State : NY
Zip : 10020-1511
Country : US
Telephone Number : 646-789-4843
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2022
Last Update Date : 10/06/2022

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