Individual
CHANTAL CHOULOUTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
92-28 215TH PL, QUEENS VILLAGE, NY 11428-1233
(718) 740-5905
Mailing address
9228 215TH PL, QUEENS VILLAGE, NY 11428-1233
(718) 740-5905
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
243509-1
NY
Other
Enumeration date
10/28/2009
Last updated
10/28/2009
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