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NPI Code Detail

MEDICARE: JOHANNA CHAMORRO MS ED

MEDICARE: JOHANNA CHAMORRO MS ED
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
1174400000XSpecialist1192046NY

General Provider Information

NPI Number : 1497090765
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHANNA CHAMORRO MS ED
Provider Business Mailing Address
First Line : 225 BROADHOLLOW RD STE 402
Second Line :
City : MELVILLE
State : NY
Zip : 11747-4899
Country : US
Telephone Number : 631-385-7780
Fax Number :
Provider Business Practice Location Address
First Line : 225 BROADHOLLOW RD STE 402
Second Line :
City : MELVILLE
State : NY
Zip : 11747-4899
Country : US
Telephone Number : 631-385-7780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2012
Last Update Date : 07/23/2020

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Directions to “ JOHANNA CHAMORRO MS ED” Practice Location

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