Healthcare Provider Details

I. General information

NPI: 1730043944
Provider Name (Legal Business Name): CHANA KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 NY-304
NANUET NY
10954
US

IV. Provider business mailing address

10 HARRIET LN
SPRING VALLEY NY
10977-1301
US

V. Phone/Fax

Practice location:
  • Phone: 845-624-8080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073568
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: