Provider Demographics
NPI:1992074132
Name:CHAITUM, PITAYA (RDMS, RDCS)
Entity type:Individual
Prefix:
First Name:PITAYA
Middle Name:
Last Name:CHAITUM
Suffix:
Gender:F
Credentials:RDMS, RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:592 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-2914
Mailing Address - Country:US
Mailing Address - Phone:201-667-0327
Mailing Address - Fax:
Practice Address - Street 1:592 RIVER RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-2914
Practice Address - Country:US
Practice Address - Phone:201-667-0327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-16
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular
No246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography