Provider Demographics
NPI:1154763894
Name:CHAIM GITELIS DO PC
Entity type:Organization
Organization Name:CHAIM GITELIS DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHAIM
Authorized Official - Middle Name:ARYEH
Authorized Official - Last Name:GITELIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-734-6621
Mailing Address - Street 1:33 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-2615
Mailing Address - Country:US
Mailing Address - Phone:718-645-1199
Mailing Address - Fax:
Practice Address - Street 1:33 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-2615
Practice Address - Country:US
Practice Address - Phone:718-534-0689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty