Provider Demographics
NPI:1720336282
Name:CHASAN, JANEEN (LCAT)
Entity Type:Individual
Prefix:
First Name:JANEEN
Middle Name:
Last Name:CHASAN
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GLEANER LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-5107
Mailing Address - Country:US
Mailing Address - Phone:516-203-6696
Mailing Address - Fax:718-845-9380
Practice Address - Street 1:11 GLEANER LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-5107
Practice Address - Country:US
Practice Address - Phone:516-203-6696
Practice Address - Fax:718-845-9380
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001545221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001545Medicaid