Individual
K. S. CLIFFORD CLIFFORD CHAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 WEST 168TH STREET, NEW YORK, NY 10032-3720
(212) 305-9987
(212) 305-0015
Mailing address
622 WEST 168TH STREET, CHONY NORTH BSMT., RM 11, NEW YORK, NY 10032-3720
(212) 305-9987
(212) 305-0015
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
251104-1
NY
2085R0001X
Radiation Oncology Physician
L6319
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03062131
—
NY
05
—
1529460301
—
TX
01
—
8G5013
BCBSTX
TX
01
—
920007185
RAIL ROAD MEDICARE
TX
Enumeration date
09/25/2006
Last updated
08/08/2012
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