Provider Demographics
NPI:1972122190
Name:BEGIAN, CHANTELLE (MD)
Entity Type:Individual
Prefix:
First Name:CHANTELLE
Middle Name:
Last Name:BEGIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 DUNDAS WAY
Mailing Address - Street 2:
Mailing Address - City:MARKHAM
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:LGE OS8
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 OCEAN PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-616-3779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-09
Last Update Date:2022-07-22
Deactivation Date:2022-01-10
Deactivation Code:
Reactivation Date:2022-07-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program