Provider Demographics
NPI:1104142298
Name:CHISARA OSMAN ADONAI MD FAMILY PRACTICE
Entity type:Organization
Organization Name:CHISARA OSMAN ADONAI MD FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:CHISARA
Authorized Official - Middle Name:OSMAN
Authorized Official - Last Name:ADONAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-273-0280
Mailing Address - Street 1:1444 MASSACHUSETTS AVE
Mailing Address - Street 2:209
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-1600
Mailing Address - Country:US
Mailing Address - Phone:518-273-0280
Mailing Address - Fax:518-273-0281
Practice Address - Street 1:1444 MASSACHUSETTS AVE
Practice Address - Street 2:209
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-1600
Practice Address - Country:US
Practice Address - Phone:518-273-0280
Practice Address - Fax:518-273-0281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty