Provider Demographics
NPI:1962044792
Name:DIGRAZIA, CHI LEE
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:LEE
Last Name:DIGRAZIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHI
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD IN CHINA
Mailing Address - Street 1:165 W 66TH ST # 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6508
Mailing Address - Country:US
Mailing Address - Phone:212-689-4367
Mailing Address - Fax:
Practice Address - Street 1:150 E 55TH ST FRNT
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4514
Practice Address - Country:US
Practice Address - Phone:212-689-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015997-1225700000X
006599-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty