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NPI Code Detail

MEDICARE: CC ANN CHAFFEE

MEDICARE:   CC ANN CHAFFEE
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1891645859
Entity Type Code : Individual
Provider Name (Legal Business Name) : CC ANN CHAFFEE
Provider Business Mailing Address
First Line : 701 W 168TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3723
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 701 W 168TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3723
Country : US
Telephone Number : 303-907-5028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2026
Last Update Date : 01/30/2026

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Directions to “ CC ANN CHAFFEE ” Practice Location

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