Provider Demographics
NPI:1760668248
Name:FELIKS CHECHELNIKER MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:FELIKS CHECHELNIKER MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:FELIKS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHECHELNIKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-934-7593
Mailing Address - Street 1:776 CALDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3619
Mailing Address - Country:US
Mailing Address - Phone:516-837-0454
Mailing Address - Fax:646-405-0174
Practice Address - Street 1:312 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6875
Practice Address - Country:US
Practice Address - Phone:718-934-7593
Practice Address - Fax:646-405-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236690261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02699989Medicaid
NY160SY2Medicare PIN