Healthcare Provider Details

I. General information

NPI: 1366724122
Provider Name (Legal Business Name): CATHERINE CHIMEZE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 LENOX RD
BROOKLYN NY
11203-2152
US

IV. Provider business mailing address

587 LENOX RD
BROOKLYN NY
11203-2152
US

V. Phone/Fax

Practice location:
  • Phone: 718-671-2100
  • Fax:
Mailing address:
  • Phone: 718-671-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number648155
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: