Individual
JEROME DONALD CHAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13 CENTURY HILL DR, LATHAM, NY 12110-2113
(518) 203-2582
(518) 203-2583
Mailing address
13 CENTURY HILL DR, LATHAM, NY 12110-2113
(518) 203-2582
(518) 203-2583
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
224758-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02429110
—
NY
Enumeration date
07/24/2006
Last updated
06/21/2010
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