Provider Demographics
NPI:1588687453
Name:CHAIMOWITZ, CHAIM (DPM)
Entity type:Individual
Prefix:DR
First Name:CHAIM
Middle Name:
Last Name:CHAIMOWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 CHURCHILL RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2903
Mailing Address - Country:US
Mailing Address - Phone:914-260-6175
Mailing Address - Fax:845-354-0611
Practice Address - Street 1:434 CHURCHILL RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2903
Practice Address - Country:US
Practice Address - Phone:914-260-6175
Practice Address - Fax:845-354-0611
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1469213EP1101X
NY3222213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00705202Medicaid
NY00705202Medicaid
NY02951Medicare ID - Type Unspecified
NY35081Medicare ID - Type Unspecified