Provider Demographics
NPI:1336139484
Name:CHAIKIN, HARRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:L
Last Name:CHAIKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:353 12TH ST S
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-2211
Mailing Address - Country:US
Mailing Address - Phone:609-266-7557
Mailing Address - Fax:609-266-4450
Practice Address - Street 1:3400 BRIGANTINE BLVD
Practice Address - Street 2:
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-1053
Practice Address - Country:US
Practice Address - Phone:609-266-7557
Practice Address - Fax:609-266-4450
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03818700207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1166409Medicaid
NJ1166409Medicaid
NJC57815Medicare UPIN