MEDICARE: MRS. ANJULI MARIE CHASE RN

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	163WS0200X	School Registered Nurse	708129	NY

General Provider Information

NPI Number	:	1700506425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANJULI MARIE CHASE RN

Provider Business Mailing Address
First Line	:	319 SUFFOLK ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-3327
Country	:	US
Telephone Number	:	716-816-4327
Fax Number	:	716-838-7528

Provider Business Practice Location Address
First Line	:	319 SUFFOLK ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215-3327
Country	:	US
Telephone Number	:	716-816-4327
Fax Number	:	716-838-7528

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

Provider Enumeration Date	:	09/01/2022
Last Update Date	:	09/01/2022

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