Provider Demographics
NPI:1912016577
Name:CHASKY, JUDAH LEO (DDS08)
Entity Type:Individual
Prefix:DR
First Name:JUDAH
Middle Name:LEO
Last Name:CHASKY
Suffix:
Gender:M
Credentials:DDS08
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4132
Mailing Address - Country:US
Mailing Address - Phone:718-382-0707
Mailing Address - Fax:718-375-9899
Practice Address - Street 1:622 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4132
Practice Address - Country:US
Practice Address - Phone:718-382-0707
Practice Address - Fax:718-375-9899
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice