Provider Demographics
NPI:1215663364
Name:SEAN R CHAPPIN MD PC
Entity type:Organization
Organization Name:SEAN R CHAPPIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-912-5203
Mailing Address - Street 1:46 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3524
Mailing Address - Country:US
Mailing Address - Phone:518-793-9820
Mailing Address - Fax:518-793-9820
Practice Address - Street 1:10 MCKOWN RD STE 109
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3496
Practice Address - Country:US
Practice Address - Phone:518-888-5507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty