MEDICARE: CHRISTOPHER LEON CHAPPELL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	018439-01	NY

General Provider Information

NPI Number	:	1083204762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER LEON CHAPPELL PT

Provider Business Mailing Address
First Line	:	16 HIGHWOOD AVE APT 2
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06850-3613
Country	:	US
Telephone Number	:	646-378-8880
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BLACKSTONE PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-3607
Country	:	US
Telephone Number	:	347-947-3132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	01/26/2021

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