Healthcare Provider Details

I. General information

NPI: 1285812057
Provider Name (Legal Business Name): CHLOE ANGELIQUE SEALES-BAILEY RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

948 48TH ST FL 2
BROOKLYN NY
11219-2918
US

IV. Provider business mailing address

445 LENOX RD
BROOKLYN NY
11203-2017
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-7219
  • Fax:
Mailing address:
  • Phone: 718-270-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number012264
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: