Basic Information
Provider Information
NPI: 1265918676
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAHINE
FirstName: ZENA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 ROSE ST STE CC-402
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8593231786
FaxNumber: 8592577715
Practice Location
Address1: 800 ROSE ST STE CC-402
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8593231786
FaxNumber: 8592577715
Other Information
ProviderEnumerationDate: 07/18/2018
LastUpdateDate: 08/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XHS000007LPAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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