MEDICARE: HAZEL J CHAMBERS MD

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	208000000X	Pediatrics Physician	106482	NY

General Provider Information

NPI Number	:	1558446906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAZEL J CHAMBERS MD

Provider Business Mailing Address
First Line	:	1500 ASTOR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-5900
Country	:	US
Telephone Number	:	718-881-0100
Fax Number	:	718-881-7752

Provider Business Practice Location Address
First Line	:	1500 ASTOR AVENUE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-5900
Country	:	US
Telephone Number	:	718-881-0100
Fax Number	:	718-881-7752

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	02/04/2010

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