Provider Demographics
NPI:1821080482
Name:CHUMAS, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:CHUMAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4567 CROSSROADS PARK DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-3589
Mailing Address - Country:US
Mailing Address - Phone:315-295-2100
Mailing Address - Fax:315-295-2125
Practice Address - Street 1:200 BELLE TERRE RD
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1928
Practice Address - Country:US
Practice Address - Phone:631-474-6183
Practice Address - Fax:631-474-6496
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2007-09-12
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Provider Licenses
StateLicense IDTaxonomies
NY132951207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY51R122Medicare PIN
NYD91652Medicare UPIN
NY10D841Medicare PIN
NY51R121Medicare PIN
NY51R123Medicare PIN
NY51R352Medicare PIN
NY51R351Medicare PIN