Provider Demographics
NPI:1326394644
Name:CHAHWAN, MARTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARTINE
Middle Name:
Last Name:CHAHWAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 WAYNE AVE APT 18F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2514
Mailing Address - Country:US
Mailing Address - Phone:347-862-8035
Mailing Address - Fax:
Practice Address - Street 1:3450 WAYNE AVE APT 18F
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2514
Practice Address - Country:US
Practice Address - Phone:347-862-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program