Healthcare Provider Details

I. General information

NPI: 1407654320
Provider Name (Legal Business Name): MEREDITH CHHAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 07/13/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 PROVIDENCE RD
BROOKLYN CT
06234-3413
US

IV. Provider business mailing address

542 PROVIDENCE RD
BROOKLYN CT
06234-3413
US

V. Phone/Fax

Practice location:
  • Phone: 860-779-0523
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN04563
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14583
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: