Provider Demographics
NPI:1184706442
Name:SCHENECTADY OTOLARYNGOLOGY HEAD & NECK SURGERY LLP
Entity type:Organization
Organization Name:SCHENECTADY OTOLARYNGOLOGY HEAD & NECK SURGERY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GILLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPADOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-347-2950
Mailing Address - Street 1:700 MCCLELLAN ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1019
Mailing Address - Country:US
Mailing Address - Phone:518-347-2950
Mailing Address - Fax:518-347-2197
Practice Address - Street 1:700 MCCLELLAN ST
Practice Address - Street 2:SUITE 700
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1019
Practice Address - Country:US
Practice Address - Phone:518-347-2950
Practice Address - Fax:518-347-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB82899OtherGILLES CHAPADOS
NYB82899OtherGILLES CHAPADOS
NYH06306Medicare UPIN
NYC58822Medicare UPIN