Individual
MRS. CARROL C CHAMBERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4211 MEDICAL CENTER DRIVE, FAYETTEVILLE, NY 13066
(315) 329-0210
(315) 329-0215
Mailing address
4211 MEDICAL CENTER DRIVE, FAYETTEVILLE, NY 13066
(315) 329-0210
(315) 329-0215
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F3009361
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02185000
—
NY
Enumeration date
02/15/2006
Last updated
07/09/2012
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