Provider Demographics
NPI:1912930181
Name:CHAIKIN, EMILY JONES (PA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JONES
Last Name:CHAIKIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 KINGS WAY STE 2700
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2554
Practice Address - Country:US
Practice Address - Phone:757-221-0110
Practice Address - Fax:757-221-0851
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001095363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1912930181Medicaid
VA016203R53Medicare PIN
P35762Medicare UPIN
VA1912930181Medicaid