Provider Demographics
NPI:1356084511
Name:CHILEUITT, KAREN ANDREA (DMD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANDREA
Last Name:CHILEUITT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3203
Mailing Address - Country:US
Mailing Address - Phone:212-686-3686
Mailing Address - Fax:
Practice Address - Street 1:1320 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3203
Practice Address - Country:US
Practice Address - Phone:212-686-3686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0631901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice