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Individual

MS. CARMELLE VIERGE CHROIRILUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
243-34 MAYDA RD, ROSEDALE, NY 11422
(718) 123-4566
Mailing address
243-34 MAYDA RD, ROSEDALE, NY 11422
(516) 424-5665

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1427305201
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2654191
NY
Enumeration date
09/01/2021
Last updated
05/01/2026
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