Individual
CHACKO XAVIOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(718) 264-4050
Mailing address
1314 K ST, ELMONT, NY 11003-3848
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
972490-01
NY
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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