Healthcare Provider Details

I. General information

NPI: 1912486051
Provider Name (Legal Business Name): CHANTEL MICHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLOMBA DR STE 2
NIAGARA FALLS NY
14305-1275
US

IV. Provider business mailing address

1 COLOMBA DR STE 2
NIAGARA FALLS NY
14305-1275
US

V. Phone/Fax

Practice location:
  • Phone: 716-453-5700
  • Fax: 716-463-5300
Mailing address:
  • Phone: 716-453-4700
  • Fax: 716-463-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number308822
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: