Provider Demographics
NPI:1871549451
Name:CHALEFF, STANLEY (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:CHALEFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 RIVERSIDE ST
Mailing Address - Street 2:SUITE 6B
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1073
Mailing Address - Country:US
Mailing Address - Phone:207-661-2000
Mailing Address - Fax:207-661-2033
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:UNIT 107
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9692
Practice Address - Country:US
Practice Address - Phone:207-885-7565
Practice Address - Fax:207-885-7577
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2017-04-27
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-11-26
Provider Licenses
StateLicense IDTaxonomies
ME0177332080P0207X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432869799Medicaid
NH30207603Medicaid
ME432869799Medicaid