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NPI Code Detail

MEDICARE: CHANTAL J GEORGES LCAT

MEDICARE: CHANTAL J GEORGES LCAT
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
1101200000XDrama Therapist001456NY

General Provider Information

NPI Number : 1629737788
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTAL J GEORGES LCAT
Provider Business Mailing Address
First Line : 281 EDGECOMBE AVE APT 4E
Second Line :
City : NEW YORK
State : NY
Zip : 10031-3019
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 451 CLARKSON AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-2054
Country : US
Telephone Number : 718-245-5439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2021
Last Update Date : 12/15/2021

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