Individual
CHAD CHITESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
31 SHERMAN ST STE 2500, JAMESTOWN, NY 14701-7082
(716) 338-9797
Mailing address
95 E CHAUTAUQUA ST, PO BOX 168, MAYVILLE, NY 14757-0168
(716) 753-7107
(716) 753-5367
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007155
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02342092
—
NY
01
—
J400003830
MEDICARE
NY
Enumeration date
10/31/2005
Last updated
06/18/2024
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