Provider Demographics
NPI:1184695462
Name:CHASEN, ROBERT S (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:CHASEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 UNION ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-2306
Mailing Address - Country:US
Mailing Address - Phone:781-335-6105
Mailing Address - Fax:
Practice Address - Street 1:54 UNION ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2306
Practice Address - Country:US
Practice Address - Phone:781-335-6105
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1582213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA33045OtherHARVARD-PILGRIM
MA703663OtherTUFTS
MA0346551Medicaid
MA703663OtherTUFTS
MAT58714Medicare UPIN