Provider Demographics
NPI:1700988060
Name:CHIN, WARREN W (MD)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:W
Last Name:CHIN
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 1:254 CANAL STREET
Mailing Address - Street 2:SUITE 3002
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:212-431-8808
Mailing Address - Fax:212-431-8836
Practice Address - Street 1:254 CANAL STREET
Practice Address - Street 2:SUITE 3002
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-431-8808
Practice Address - Fax:212-431-8836
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150386207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00768562Medicaid
NY00768562Medicaid
C12053Medicare UPIN