MEDICARE: DENENE CHANDLER

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	347C00000X	Private Vehicle	25737542	PA

General Provider Information

NPI Number	:	1598585663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENENE CHANDLER

Provider Business Mailing Address
First Line	:	6018 REACH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5911
Country	:	US
Telephone Number	:	267-709-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	6018 REACH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-5911
Country	:	US
Telephone Number	:	267-709-1400
Fax Number	:

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

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	10/14/2024

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Directions to “ DENENE CHANDLER ” Practice Location

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