Individual
DR. DALI CHAKHVASHVILI MARDACH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
(718) 963-6551
(718) 963-6793
Mailing address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
(718) 963-6551
(718) 963-6793
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
225309
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02358634
—
NY
Enumeration date
01/03/2006
Last updated
07/08/2007
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