Provider Demographics
NPI:1417015835
Name:CHORZEMPA, AMY M (ANP-BC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:CHORZEMPA
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:C
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:55 FRUIT STREET
Mailing Address - Street 2:MGH: ELECTROPHYSIOLOGY DEPARTMENT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-724-5752
Mailing Address - Fax:212-523-3915
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:S&R 3-CARDIOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:212-523-4008
Practice Address - Fax:212-523-3915
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF 303703363LA2200X
NYF303703363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health