Provider Demographics
NPI:1497944862
Name:CHAIKEN, BARRY G (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:G
Last Name:CHAIKEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BARRY
Other - Middle Name:G
Other - Last Name:CHAIKEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:625 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6545
Mailing Address - Country:US
Mailing Address - Phone:212-249-1976
Mailing Address - Fax:212-249-3712
Practice Address - Street 1:625 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6545
Practice Address - Country:US
Practice Address - Phone:212-249-1976
Practice Address - Fax:212-249-3712
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131353207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00460366Medicaid
NY1457673964OtherNPI
NY0274600001Medicare NSC
NY1457673964OtherNPI
NY25A581Medicare PIN