Individual
MIREILLE CHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 GRANT CT, AUGUSTA, NJ 07822-2159
(718) 828-2666
Mailing address
1 GRANT CT, AUGUSTA, NJ 07822-2159
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
476906
NY
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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