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NPI Code Detail

MEDICARE: MARQUIS CHANDLER LSW

MEDICARE: MARQUIS CHANDLER LSW
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
1104100000XSocial Worker44SL06906900NJ

General Provider Information

NPI Number : 1275212003
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARQUIS CHANDLER LSW
Provider Business Mailing Address
First Line : 121 GARABRANT ST UNIT 205
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07304-4187
Country : US
Telephone Number : 551-200-8182
Fax Number :
Provider Business Practice Location Address
First Line : 373 CLERMONT TER
Second Line :
City : UNION
State : NJ
Zip : 07083-8073
Country : US
Telephone Number : 551-200-8182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2023
Last Update Date : 07/18/2023

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Directions to “ MARQUIS CHANDLER LSW” Practice Location

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