Provider Demographics
NPI:1104310341
Name:CHASON, ERIC BENJAMIN (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BENJAMIN
Last Name:CHASON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EAST 60TH STREET
Mailing Address - Street 2:SUITE #704
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-242-4488
Mailing Address - Fax:212-242-3975
Practice Address - Street 1:30 EAST 60TH STREET
Practice Address - Street 2:SUITE #704
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-242-4488
Practice Address - Fax:212-242-3975
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0605271223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice