Individual
MR. MARK D CHAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3085 HARLEM ROAD, SUITE 200, CHEEKTOWAGA, NY 14225-2591
(716) 844-5000
(716) 844-5050
Mailing address
3085 HARLEM ROAD, SUITE 200, CHEEKTOWAGA, NY 14225-2591
(716) 844-5000
(716) 844-5050
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
191098
NY
208800000X
Urology Physician
Primary
191098-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010297801
UNIVERA INSURANCE
NY
01
—
005247231
BLUE CROSS
NY
05
—
01739899
—
NY
01
—
1099639
GHI
NY
01
—
160985156
UHC-EMPIRE
—
01
—
1908966
INDEPENDENT HEALTH INS
NM
01
—
340013524
RAILROAD MEDICARE
NY
Enumeration date
02/14/2006
Last updated
03/01/2011
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