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Individual

MICHELE CHAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5861
Mailing address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5861

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
231377-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000161738
BLUE SHIELD
NY
05
02320432
NY
01
161300613
TAX ID
NY
01
41122000036
FIDELIS
NY
Enumeration date
07/17/2006
Last updated
05/26/2010
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