Provider Demographics
NPI:1518359751
Name:CHAMBERLAIN, MARGUERITE
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:CHAMBERLAIN
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 1:7701 LINDBERGH BLVD
Mailing Address - Street 2:#509
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19153-2132
Mailing Address - Country:US
Mailing Address - Phone:215-365-3385
Mailing Address - Fax:
Practice Address - Street 1:8711 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-1115
Practice Address - Country:US
Practice Address - Phone:215-840-5960
Practice Address - Fax:610-449-5272
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator