Provider Demographics
NPI:1841278355
Name:CHITAYAT, SAMMY (MD)
Entity type:Individual
Prefix:
First Name:SAMMY
Middle Name:
Last Name:CHITAYAT
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 1:110 E 59TH ST
Mailing Address - Street 2:SUITE 9A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1304
Mailing Address - Country:US
Mailing Address - Phone:212-535-1400
Mailing Address - Fax:212-644-2111
Practice Address - Street 1:110 E 59TH ST
Practice Address - Street 2:SUITE 9A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1304
Practice Address - Country:US
Practice Address - Phone:212-535-1400
Practice Address - Fax:212-644-2111
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246855Medicaid
NY324652Medicare PIN
NYB13025Medicare UPIN