Individual
CHATARRA PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
365 BROADWAY, SUITE 4A, AMITYVILLE, NY 11701-2716
(631) 608-8523
Mailing address
19 ESSEN DR, AMITYVILLE, NY 11701-1821
(631) 889-9452
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
323369
NY
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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