Individual
CHAVIVAN DHARAPAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
290 RIDGECREST AVE, STATEN ISLAND, NY 10312-5134
(718) 967-1114
(718) 967-1114
Mailing address
290 RIDGECREST AVE, STATEN ISLAND, NY 10312-5134
(718) 967-1114
(718) 967-1114
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
148151
NY
Other
Enumeration date
09/24/2011
Last updated
09/24/2011
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