Individual
CHANELE ASSENCOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
465 E 7TH ST APT 3J, BROOKLYN, NY 11218-4840
(774) 285-6419
Mailing address
465 E 7TH ST APT 3J, BROOKLYN, NY 11218-4840
(774) 285-6419
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
019731-1
NY
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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