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Individual

JAY W CHAPMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6564
(315) 298-3968
Mailing address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6564
(315) 298-3968

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
144846
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00144846
NY
05
00307662
NY
01
331880
FQHC NUMBER
NY
Enumeration date
09/02/2005
Last updated
10/06/2014
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