Provider Demographics
NPI:1801783188
Name:CHIYAL, EDWIN RAFAEL
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:RAFAEL
Last Name:CHIYAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-3132
Mailing Address - Country:US
Mailing Address - Phone:337-435-4822
Mailing Address - Fax:
Practice Address - Street 1:3929 SPENCER ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3132
Practice Address - Country:US
Practice Address - Phone:337-435-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker