Provider Demographics
NPI:1255325650
Name:CHOUCHANI, ADEL EMIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEL
Middle Name:EMIL
Last Name:CHOUCHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N UNION RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5367
Mailing Address - Country:US
Mailing Address - Phone:716-633-6363
Mailing Address - Fax:716-633-4419
Practice Address - Street 1:30 N UNION RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5367
Practice Address - Country:US
Practice Address - Phone:716-633-6363
Practice Address - Fax:716-633-4419
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148116207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0708668OtherINDEPENDENT HEALTH
NY000500088007OtherBLUECROSS BLUESHIELD
NY00010030702OtherUNIVERA
NY00765962Medicaid
NY00765962Medicaid