Provider Demographics
NPI:1821359092
Name:CHAPPELL, BARON THOMAS JR
Entity Type:Individual
Prefix:MR
First Name:BARON
Middle Name:THOMAS
Last Name:CHAPPELL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-1503
Mailing Address - Country:US
Mailing Address - Phone:716-882-2127
Mailing Address - Fax:716-882-9277
Practice Address - Street 1:1300 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1503
Practice Address - Country:US
Practice Address - Phone:716-882-2127
Practice Address - Fax:716-882-9277
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker