Provider Demographics
NPI:1437467743
Name:CHAMBERS, STEPHANIE MELISSA (NP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MELISSA
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MELISSA
Other - Last Name:CHAMBERS-GRAVES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:105 STEVENS AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2680
Mailing Address - Country:US
Mailing Address - Phone:718-704-0907
Mailing Address - Fax:888-489-1787
Practice Address - Street 1:105 STEVENS AVE STE 408
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2680
Practice Address - Country:US
Practice Address - Phone:718-704-0907
Practice Address - Fax:888-489-1787
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily