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General NPI Number Information
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NPI Number | 1902395155
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Entity Type | Individual
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Provider Name | MICHELLE CHOW
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Gender | Male
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Dates
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Enumeration Date | 05/03/2018
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Last Update Date | 05/03/2018
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Provider Practice Location Address
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Address Line | 22342 112TH RD FL 2
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429-2703
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Country | US
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Telephone | 347-299-9486
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Fax |
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Provider Business Mailing Address
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Address Line | 22342 112TH RD FL 2
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City | QUEENS VILLAGE
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State | NY
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Zip | 11429-2703
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Country | US
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Telephone |
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | L-110776
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License Number State |
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