Provider Demographics
NPI:1477623411
Name:CHHIPA, MOHAMMAD HAROON (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:HAROON
Last Name:CHHIPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17035 83RD AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2101
Mailing Address - Country:US
Mailing Address - Phone:718-297-4506
Mailing Address - Fax:
Practice Address - Street 1:4071 ELBERTSON ST
Practice Address - Street 2:STE A17
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2162
Practice Address - Country:US
Practice Address - Phone:718-205-7400
Practice Address - Fax:718-205-7400
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240016208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics