Provider Demographics
NPI:1326333287
Name:CHESTER, MICHELLE ANTOINTTE (FNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANTOINTTE
Last Name:CHESTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 DR REED BLVD
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1219
Mailing Address - Country:US
Mailing Address - Phone:347-992-6941
Mailing Address - Fax:
Practice Address - Street 1:410 LAKEVILLE RD STE 206
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1122
Practice Address - Country:US
Practice Address - Phone:516-306-5259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY336787363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily