Provider Demographics
NPI:1982662995
Name:CHAIKOF, ELLIOT L (MD)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:L
Last Name:CHAIKOF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 FRANCIS ST
Mailing Address - Street 2:SUITE 9F
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5501
Mailing Address - Country:US
Mailing Address - Phone:617-632-9581
Mailing Address - Fax:617-632-9701
Practice Address - Street 1:110 FRANCIS ST
Practice Address - Street 2:SUITE 9F
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5501
Practice Address - Country:US
Practice Address - Phone:617-632-9581
Practice Address - Fax:617-632-9701
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2011-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA552112086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A59121Medicare UPIN
77BBBBDMedicare ID - Type Unspecified