Provider Demographics
NPI:1932406303
Name:CHIRA, MARILYN RACHEL (PA)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:RACHEL
Last Name:CHIRA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:50 E 69TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5002
Mailing Address - Country:US
Mailing Address - Phone:212-628-7300
Mailing Address - Fax:212-988-0158
Practice Address - Street 1:50 E 69TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5002
Practice Address - Country:US
Practice Address - Phone:212-628-7300
Practice Address - Fax:212-988-0158
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014560363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical