Provider Demographics
NPI:1568014256
Name:CHESTER, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:CHESTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 W 238TH ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4271
Mailing Address - Country:US
Mailing Address - Phone:646-334-8833
Mailing Address - Fax:
Practice Address - Street 1:1775 GRAND CONCOURSE FL 8
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-8202
Practice Address - Country:US
Practice Address - Phone:212-560-6700
Practice Address - Fax:212-244-2034
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker