Provider Demographics
NPI:1467574632
Name:MICHAEL J. CHANDLER MD, PLLC
Entity Type:Organization
Organization Name:MICHAEL J. CHANDLER MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SYMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-486-6715
Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8183
Mailing Address - Country:US
Mailing Address - Phone:212-486-6715
Mailing Address - Fax:212-935-0092
Practice Address - Street 1:115 E 61ST ST
Practice Address - Street 2:SUITE 12
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8183
Practice Address - Country:US
Practice Address - Phone:212-486-6715
Practice Address - Fax:212-935-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Not Answered2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB17892Medicare UPIN
NY4255F1Medicare ID - Type Unspecified
NY068D02Medicare ID - Type Unspecified
NY5B4931Medicare ID - Type Unspecified
NY14G883Medicare ID - Type Unspecified
NYH63837Medicare UPIN
NYF59101Medicare UPIN
NYI41155Medicare UPIN