Individual
CHAILLE MINTAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 HOBART ST, RESIDENCY PROGRAM, UTICA, NY 13501
(315) 801-1149
(315) 801-3565
Mailing address
120 HOBART ST, RESIDENCY PROGRAM, UTICA, NY 13501-4308
(315) 801-1149
(315) 801-3565
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
295435
NY
207Q00000X
Family Medicine Physician
Primary
295435
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2015
Last updated
08/09/2018
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