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Individual

KEVIN CHASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100TH STREET AND MADISON AVE, NEW YORK, NY 10029
(212) 241-0101
(212) 426-5083
Mailing address
BOX 1149, ONE GUSTAVE LEVY PLACE, NEW YORK, NY 10029
(212) 241-6794
(212) 426-5083

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2032141
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01859301
NY
01
930078505
RR MEDICARE
NY
Enumeration date
03/08/2006
Last updated
04/22/2008
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