Individual
DR. BRENT IRA CHABUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
161 MADISON AVE, SUITE 10NW, NEW YORK, NY 10016-5421
(212) 477-5698
(212) 696-9411
Mailing address
10 SWANS MILL LN, SCOTCH PLAINS, NJ 07076-3406
(212) 477-5698
(917) 677-6621
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
168233
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01143402
—
NY
Enumeration date
10/02/2006
Last updated
04/05/2021
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