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Contact Information

DOUGLAS CHISOLM, C.R.N.A.
170 WILLIAM ST
NEW YORK, NY10038-2612
 Phone: 212-312-5244
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for DOUGLAS CHISOLM · (Male)

NPI Number 1811993496
Status Active
Credentials C.R.N.A.
Entity Individual
Enumeration date 06/28/2005
Last updated 02/13/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NY License # 362886
  • NY License # 3628861
Hospital affiliation(s)
  • SOUTHSIDE HOSPITAL - (Acute Care)
    301 EAST MAIN STREET
    BAY SHORE, NY 11706
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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