KIYOSHI TAIBU CHANDLER DO
NPI 1013764968
Student in an Organized Health Care Education/Training Program in Smithtown, NY

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 30, 2024

50 ROUTE 25A, SMITHTOWN, NY 11787(631) 376-4163 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Kiyoshi Taibu Chandler Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIYOSHI TAIBU CHANDLER DO (NPI 1013764968) is an individual student in an organized health care education/training program in Smithtown, New York and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1013764968

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameKIYOSHI TAIBU CHANDLERCredential: DO

Location Address50 ROUTE 25ASmithtown, NY 11787-1348

Mailing Address1000 Montauk HwyWest Islip, NY 11795-4927 · Fax (631) 376-3420

Phone(631) 376-4163

Sole ProprietorNo

Enumeration DateApril 30, 2024

NPPES CertifiedApril 30, 2024

✔ NPI 1013764968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

50 ROUTE 25A, Smithtown, NY 11787

Open in Google Maps ↗