Provider Demographics
NPI:1770567034
Name:HARRIS-CHIN, CHERYL J (MD, FAAP)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:J
Last Name:HARRIS-CHIN
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 WINNERS CIR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:DE
Mailing Address - Zip Code:19962-9739
Mailing Address - Country:US
Mailing Address - Phone:302-335-2642
Mailing Address - Fax:302-335-4600
Practice Address - Street 1:771 E MASTEN CIR
Practice Address - Street 2:SUITE 115
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1088
Practice Address - Country:US
Practice Address - Phone:302-424-8404
Practice Address - Fax:302-424-0208
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0007171208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG90124Medicare UPIN