Provider Demographics
NPI:1568906675
Name:CHINIQUE-FEASTER, NORMA (BA)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:CHINIQUE-FEASTER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 MARGARET PL
Mailing Address - Street 2:
Mailing Address - City:LANOKA HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08734-1619
Mailing Address - Country:US
Mailing Address - Phone:609-709-9744
Mailing Address - Fax:
Practice Address - Street 1:805 MARGARET PL
Practice Address - Street 2:
Practice Address - City:LANOKA HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08734-1619
Practice Address - Country:US
Practice Address - Phone:609-709-9744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor