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NPI Code Detail

MEDICARE: CHANTAL VICE

MEDICARE: CHANTAL VICE
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1487251047
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTAL VICE
Provider Business Mailing Address
First Line : 12 LOWERRE ST
Second Line :
City : BABYLON
State : NY
Zip : 11702-2506
Country : US
Telephone Number : 917-538-7632
Fax Number :
Provider Business Practice Location Address
First Line : 68 S SERVICE RD STE 100
Second Line :
City : MELVILLE
State : NY
Zip : 11747-2350
Country : US
Telephone Number : 516-430-8362
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2020
Last Update Date : 01/20/2026

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Directions to “ CHANTAL VICE ” Practice Location

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