Basic Information
Provider Information
NPI: 1720620149
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPMAN
FirstName: CHRISTOPHER
MiddleName: RYAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 450 CLARKSON AVE # MSC30
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112032012
CountryCode: US
TelephoneNumber: 7182702045
FaxNumber: 7182703983
Practice Location
Address1: 450 CLARKSON AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112032012
CountryCode: US
TelephoneNumber: 7182701000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/17/2019
LastUpdateDate: 07/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XP3100X300335NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery

No ID Information.


Home