Provider Demographics
NPI:1093795460
Name:FICHANDLER, CHESTER S (OD)
Entity Type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:S
Last Name:FICHANDLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2079
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-0002
Mailing Address - Country:US
Mailing Address - Phone:516-798-8903
Mailing Address - Fax:
Practice Address - Street 1:743 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4524
Practice Address - Country:US
Practice Address - Phone:516-746-2360
Practice Address - Fax:516-294-1937
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003179-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY112768801OtherUNITED HEALTHCARE
NYP824156OtherOXFORD
NY1C7776OtherHEALTHNET
NY00677541Medicaid
NY112768801OtherUNITED HEALTHCARE
NY0340490001Medicare NSC
NYC29951Medicare PIN