Provider Demographics
NPI:1649254236
Name:CHINITZ, ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:CHINITZ
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 1:1 VALLEY HEALTH PLZ
Mailing Address - Street 2:LUCKOW PAVILION
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3628
Mailing Address - Country:US
Mailing Address - Phone:201-634-5600
Mailing Address - Fax:201-634-5601
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:LUCKOW PAVILION
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-634-5600
Practice Address - Fax:201-634-5601
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02427900207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2688506Medicaid
C56314Medicare UPIN
NJ462076Medicare ID - Type Unspecified