Basic Information
Provider Information
NPI: 1003152281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPIN
FirstName: BRIAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 53 ORMOND ST
Address2:  
City: ALBANY
State: NY
PostalCode: 122032303
CountryCode: US
TelephoneNumber: 6072262277
FaxNumber:  
Practice Location
Address1: 53 ORMOND ST
Address2:  
City: ALBANY
State: NY
PostalCode: 122032303
CountryCode: US
TelephoneNumber: 6072262277
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/17/2012
LastUpdateDate: 12/17/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X033.0047442VTN Pharmacy Service ProvidersPharmacist 
183500000X056510NYY Pharmacy Service ProvidersPharmacist 

No ID Information.


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