Provider Demographics
NPI:1700187317
Name:PORCHIA-ALBERT, CHANEL LAUREN (CD,CLC)
Entity Type:Individual
Prefix:
First Name:CHANEL
Middle Name:LAUREN
Last Name:PORCHIA-ALBERT
Suffix:
Gender:F
Credentials:CD,CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHURCH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2761
Mailing Address - Country:US
Mailing Address - Phone:347-778-3490
Mailing Address - Fax:347-787-4534
Practice Address - Street 1:743 HANCOCK ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1204
Practice Address - Country:US
Practice Address - Phone:347-512-8155
Practice Address - Fax:347-787-4534
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula