Healthcare Provider Details

I. General information

NPI: 1598040834
Provider Name (Legal Business Name): YOLA J CHAMBERS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 WATERS PL
BRONX NY
10461-2700
US

IV. Provider business mailing address

11 YORKSHIRE PL
YONKERS NY
10701-5930
US

V. Phone/Fax

Practice location:
  • Phone: 347-493-8503
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number517734-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: