Provider Demographics
NPI:1184200503
Name:BRIJLALL, CHANDROUTIE (RN)
Entity Type:Individual
Prefix:
First Name:CHANDROUTIE
Middle Name:
Last Name:BRIJLALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E GUN HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6016
Mailing Address - Country:US
Mailing Address - Phone:718-944-3189
Mailing Address - Fax:
Practice Address - Street 1:2000 E GUN HILL RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6016
Practice Address - Country:US
Practice Address - Phone:718-944-3189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY488917-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse