Provider Demographics
NPI:1003540469
Name:CHAIM ADLER DDS ORTHODONTICS PC
Entity Type:Organization
Organization Name:CHAIM ADLER DDS ORTHODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMPRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-415-6130
Mailing Address - Street 1:414 NY 59
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 NY 59
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952
Practice Address - Country:US
Practice Address - Phone:845-678-3306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04992527Medicaid
NY05919177Medicaid