Provider Demographics
NPI:1780745299
Name:CHALIK, NATALYA (MD)
Entity type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:CHALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RALPH PLACE SUITE 305
Mailing Address - Street 2:EMERSON MEDICAL
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304
Mailing Address - Country:US
Mailing Address - Phone:718-448-3800
Mailing Address - Fax:718-448-2003
Practice Address - Street 1:11 RALPH PLACE SUITE 305
Practice Address - Street 2:EMERSON MEDICAL
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304
Practice Address - Country:US
Practice Address - Phone:718-448-3800
Practice Address - Fax:718-448-2003
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229483207R00000X
NJ25MA07633200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02530716Medicaid
P2995181OtherOXFORD
I03208Medicare UPIN
NY02530716Medicaid