MEDICARE: CINDY CHI FNP-C

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	363LF0000X	Family Nurse Practitioner	F336508	NY

General Provider Information

NPI Number	:	1619278538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY CHI FNP-C

Provider Business Mailing Address
First Line	:	825 57TH ST
Second Line	:	SUITE 102
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3648
Country	:	US
Telephone Number	:	718-676-1550
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 57TH ST
Second Line	:	SUITE 102
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3648
Country	:	US
Telephone Number	:	718-676-1550
Fax Number	:

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

Provider Enumeration Date	:	11/09/2010
Last Update Date	:	07/19/2013

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