Individual provider Active NPI

Nina Chabanov, SE

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1801563259
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1118697 Issued in NY
Practice address
704 Avenue X FL 2
Brooklyn, NY 11235-6121
Phone
(347) 307-2350
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1118697 NY Primary

Addresses

Primary practice location

704 Avenue X FL 2
Brooklyn, NY 11235-6121

Mailing address

909 Avenue T Apt A3
Brooklyn, NY 11223-3306
Phone (347) 401-2677

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1118697NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1801563259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 AVENUE T APT A3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233306",
            "telephone_number": "347-401-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 AVENUE X FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112356121",
            "telephone_number": "347-307-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHABANOV",
        "first_name": "NINA",
        "credential": "SE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1118697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.