Individual
ROBERT MARK CHASUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1180 NEWFIELD AVE, STAMFORD, CT 06905-1409
(314) 888-5233
Mailing address
1180 NEWFIELD AVE, STAMFORD, CT 06905-1409
(314) 888-5233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07595
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080070636
RAILROAD MEDICARE
LA
05
—
1369781
—
LA
Enumeration date
08/12/2005
Last updated
03/17/2023
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