Active NPI
Edward V Chin, PA
- Physician Assistant
- New York, NY
National Provider Identifier
1124145941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 02080
- Practice address
- 1275 York Ave
New York, New York
New York, NY 10065-6007 - Phone
- (212) 639-8114
- Fax
- (646) 422-2237
- NPI assigned
- Mar 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 002080 | NY | |
| Physician Assistant | 363A00000X | 02080 | NY | Primary |
Addresses
Primary practice location
1275 York Ave
New York, New York
New York, NY 10065-6007
Mailing address
1275 York Ave
New York, New York
New York, NY 10065-6007
Phone (212) 639-8114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002080 | NY | MD | Infectious Disease Physician |
| 02080 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310947200000",
"number": "1124145941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 YORK AVE",
"address_2": "NEW YORK, NEW YORK",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100656007",
"telephone_number": "212-639-8114",
"fax_number": "646-422-2237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 YORK AVE",
"address_2": "NEW YORK, NEW YORK",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100656007",
"telephone_number": "212-639-8114",
"fax_number": "646-422-2237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHIN",
"first_name": "EDWARD",
"middle_name": "V",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-25",
"last_updated": "2011-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "002080",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "02080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.