Provider Demographics
NPI:1467512418
Name:CHALNICK, ADAM SCOTT (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SCOTT
Last Name:CHALNICK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 OCEAN PKWY
Mailing Address - Street 2:APT LA
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7749
Mailing Address - Country:US
Mailing Address - Phone:718-769-7800
Mailing Address - Fax:718-934-5478
Practice Address - Street 1:2650 OCEAN PKWY
Practice Address - Street 2:APT LA
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7749
Practice Address - Country:US
Practice Address - Phone:718-769-7800
Practice Address - Fax:718-934-5478
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005735-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02246142Medicaid
NYPG4781Medicare PIN
NY02246142Medicaid