1700249356 NPI number — CHAMBERS CERTIFIED REGISTERED NURSE ANESTHETIST PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700249356 NPI number — CHAMBERS CERTIFIED REGISTERED NURSE ANESTHETIST PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHAMBERS CERTIFIED REGISTERED NURSE ANESTHETIST PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700249356
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11402 135TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH OZONE PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11420-3117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-816-7267
Provider Business Mailing Address Fax Number:
347-809-4399

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 BRIGHTON BEACH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11235-8066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-816-7267
Provider Business Practice Location Address Fax Number:
347-809-4399
Provider Enumeration Date:
03/31/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CHAMBERS
Authorized Official First Name:
TRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
917-816-7267

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  477079 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com