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General NPI Number Information
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NPI Number | 1326394560
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Entity Type | Individual
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Provider Name | MS. STEPHANIE CHAVARRIAGA
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Gender | Female
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 535 8TH AVE 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10018-4305
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Country | US
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Telephone | 212-787-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 3525 95TH ST APT. C10
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-8510
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Country | US
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Telephone | 347-870-8164
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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