MEDICARE: MS. AERIEL MICHELLA CHAMBERS

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	163WM0102X	Maternal Newborn Registered Nurse	683360	NY
2	363LW0102X	Women's Health Nurse Practitioner	421541	NY

General Provider Information

NPI Number	:	1558939827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AERIEL MICHELLA CHAMBERS

Provider Business Mailing Address
First Line	:	1254 E 85TH ST FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4926
Country	:	US
Telephone Number	:	347-733-0235
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 E 14TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7283
Country	:	US
Telephone Number	:	347-541-6241
Fax Number	:

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

Provider Enumeration Date	:	06/14/2021
Last Update Date	:	02/19/2023

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