MEDICARE: ERICA CHAMBERS

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	104100000X	Social Worker	RO44237 1	NY

General Provider Information

NPI Number	:	1184697138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA CHAMBERS

Provider Business Mailing Address
First Line	:	380 ROUTE 202
Second Line	:
City	:	SOMERS
State	:	NY
Zip	:	10589-3222
Country	:	US
Telephone Number	:	914-617-9068
Fax Number	:	914-669-5165

Provider Business Practice Location Address
First Line	:	380 ROUTE 202
Second Line	:
City	:	SOMERS
State	:	NY
Zip	:	10589-3222
Country	:	US
Telephone Number	:	914-617-9068
Fax Number	:	914-617-9068

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	06/21/2011

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