Individual
JONATHAN T CHAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5861
(315) 448-6167
Mailing address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5861
(315) 448-6167
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
231603-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000161554
BLUE SHIELD
NY
05
—
02313293
—
NY
01
—
161300613
TAX ID
NY
01
—
41122000039
FIDELIS
NC
01
—
4129160
MVP
NC
Enumeration date
07/21/2006
Last updated
05/16/2008
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