Healthcare Provider Details

I. General information

NPI: 1275880973
Provider Name (Legal Business Name): NOSTRAND AMBULATORY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 NOSTRAND AVE
BROOKLYN NY
11229-5107
US

IV. Provider business mailing address

1534 VICTORY BLVD
STATEN ISLAND NY
10314-3548
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-3577
  • Fax: 718-667-3043
Mailing address:
  • Phone: 718-667-3577
  • Fax: 718-667-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KENNETH B CHAPMAN
Title or Position: OWNER
Credential: M.D.
Phone: 718-667-3577