Provider Demographics
NPI:1245296649
Name:CHINMAN, GARY ANDREW (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:ANDREW
Last Name:CHINMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 BEACON STREET
Mailing Address - Street 2:SUITE 346
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3200
Mailing Address - Country:US
Mailing Address - Phone:617-738-8900
Mailing Address - Fax:617-738-3900
Practice Address - Street 1:1330 BEACON STREET
Practice Address - Street 2:SUITE 346
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446
Practice Address - Country:US
Practice Address - Phone:617-738-8900
Practice Address - Fax:617-738-3900
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA733242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry