Provider Demographics
NPI:1376670026
Name:CHIARELLA, JOSEPH ANTHONY III (M D)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:CHIARELLA
Suffix:III
Gender:M
Credentials:M D
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Mailing Address - Street 1:116 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1338
Mailing Address - Country:US
Mailing Address - Phone:212-856-4674
Mailing Address - Fax:212-856-4619
Practice Address - Street 1:150 E 42ND ST
Practice Address - Street 2:26TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5612
Practice Address - Country:US
Practice Address - Phone:212-856-4674
Practice Address - Fax:212-856-4619
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY163180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64480Medicare UPIN