Individual
DR. MIRANDA CHAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5131 RIVER CLUB DR STE 200, SUFFOLK, VA 23435-3837
(804) 207-6737
Mailing address
104 KNIGHT ST, OCEANSIDE, NY 11572-4611
(718) 270-1748
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101053901
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20H872
—
NY
Enumeration date
03/26/2006
Last updated
03/19/2025
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