Provider Demographics
NPI:1063108199
Name:CHAFFIN, ELLA MARIA (DO)
Entity type:Individual
Prefix:DR
First Name:ELLA
Middle Name:MARIA
Last Name:CHAFFIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 W 158TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7104
Mailing Address - Country:US
Mailing Address - Phone:866-463-2778
Mailing Address - Fax:
Practice Address - Street 1:610 W 158TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-7104
Practice Address - Country:US
Practice Address - Phone:866-463-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program