Individual
MS. CHANTALE PHILISTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
2681 W 2ND ST, APT 5C, BROOKLYN, NY 11223-6377
(929) 220-6062
(718) 676-9238
Mailing address
2505 BOSWELL STREET, DELTONA, FL 32738-9306
(929) 220-6062
(718) 676-9238
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200023-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215275318
—
NY
Enumeration date
01/23/2013
Last updated
06/11/2021
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