Healthcare Provider Details

I. General information

NPI: 1700187317
Provider Name (Legal Business Name): CHANEL LAUREN PORCHIA-ALBERT CD,CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 HANCOCK ST SECOND FLOOR
BROOKLYN NY
11233-1204
US

IV. Provider business mailing address

50 CHURCH ST STE 105
MONTCLAIR NJ
07042-2761
US

V. Phone/Fax

Practice location:
  • Phone: 347-512-8155
  • Fax: 347-787-4534
Mailing address:
  • Phone: 347-778-3490
  • Fax: 347-787-4534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: