MEDICARE: PEMA CHODON

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	163W00000X	Registered Nurse	851350	NY

General Provider Information

NPI Number	:	1609571215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEMA CHODON

Provider Business Mailing Address
First Line	:	89 BARTLETT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-4463
Country	:	US
Telephone Number	:	718-828-2666
Fax Number	:

Provider Business Practice Location Address
First Line	:	4027 68TH ST
Second Line	:
City	:	WOODSIDE
State	:	NY
Zip	:	11377-2962
Country	:	US
Telephone Number	:	347-459-6208
Fax Number	:

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

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	04/03/2023

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Directions to “ PEMA CHODON ” Practice Location

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