Individual
CHANELLE JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1650 EASTERN PKWY, BROOKLYN, NY 11233-4804
(718) 255-5946
Mailing address
1650 EASTERN PKWY, BROOKLYN, NY 11233-4804
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04940272
—
NY
Enumeration date
01/23/2019
Last updated
01/23/2019
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