MEDICARE: MS. JEANNE MARY CHARTIER ANP

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	363LA2200X	Adult Health Nurse Practitioner	F301738	NY

General Provider Information

NPI Number	:	1316923766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEANNE MARY CHARTIER ANP

Provider Business Mailing Address
First Line	:	130 GALE PL
Second Line	:	APT 3F
City	:	BRONX
State	:	NY
Zip	:	10463-2844
Country	:	US
Telephone Number	:	718-601-5213
Fax Number	:	718-601-5819

Provider Business Practice Location Address
First Line	:	130 W KINGSBRIDGE RD
Second Line	:	URGENT CARE
City	:	BRONX
State	:	NY
Zip	:	10468-3904
Country	:	US
Telephone Number	:	718-584-9000
Fax Number	:	718-741-4650

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	07/08/2007

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