Doctor Name: | MR. LARRY BERNARD CHASIN |
NPI Number: | 1588654156 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 003236 1 |
Business Practice Address: | 155 County Rd Cresskill, NJ - 076262200 |
Business Phone Number: | 2015675609 |
Business Fax Number: | |
Mailing Address: | 155 County Rd, CRESSKILL |
State: | NJ |
Postal Code: | 076262200 |
Phone Number: | 2015675609 |
Fax Number: | |
NPI Enumeration Date: | 10/25/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 003236 1 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |