Provider Demographics
NPI:1740228147
Name:CHAIKEN, RITA ROSINEK X (AUD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:ROSINEK
Last Name:CHAIKEN
Suffix:X
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 FIELDSTONE DR
Mailing Address - Street 2:STE. 106
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7106
Mailing Address - Country:US
Mailing Address - Phone:478-452-0578
Mailing Address - Fax:478-453-0967
Practice Address - Street 1:6022 SANDY SPRINGS CIR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3832
Practice Address - Country:US
Practice Address - Phone:404-256-5194
Practice Address - Fax:404-256-5114
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA447231H00000X
GA000447231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA637568DMedicaid
GA64PCBGWMedicare UPIN