Individual
MRS. CHANTAL ISABEL LOURES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
157-15 46TH AVE, FLUSHING, NY 11355-2353
(718) 445-3029
Mailing address
125 EAGLE ST APT 2, BROOKLYN, NY 11222-5486
(732) 547-2729
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383041
NY
Other
Enumeration date
11/07/2013
Last updated
09/01/2019
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