Provider Demographics
NPI:1497910780
Name:CHALAIRE, JENNIFER JANE (LPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JANE
Last Name:CHALAIRE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 BROWNS RD
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-3236
Mailing Address - Country:US
Mailing Address - Phone:631-285-1017
Mailing Address - Fax:
Practice Address - Street 1:407 BROWNS RD
Practice Address - Street 2:
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-3236
Practice Address - Country:US
Practice Address - Phone:631-285-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279240-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse