Provider Demographics
NPI:1861930463
Name:CHADAEV, ALEXANDER S
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:S
Last Name:CHADAEV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7206
Mailing Address - Country:US
Mailing Address - Phone:646-226-6831
Mailing Address - Fax:
Practice Address - Street 1:40 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-7206
Practice Address - Country:US
Practice Address - Phone:646-226-6831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant