Provider Demographics
NPI:1417218272
Name:FIDDLE, EMILY CHANIE
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:CHANIE
Last Name:FIDDLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3301
Mailing Address - Country:US
Mailing Address - Phone:718-376-1690
Mailing Address - Fax:718-376-1690
Practice Address - Street 1:1941 E 13TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3301
Practice Address - Country:US
Practice Address - Phone:718-376-1690
Practice Address - Fax:718-376-1690
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator