Provider Demographics
NPI:1700227352
Name:CHAMBERS, CAROLYN B (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:B
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:B
Other - Last Name:MONACO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:124 SLEEPY HOLLOW DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-5838
Mailing Address - Country:US
Mailing Address - Phone:302-449-3030
Mailing Address - Fax:302-449-3040
Practice Address - Street 1:124 SLEEPY HOLLOW DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5838
Practice Address - Country:US
Practice Address - Phone:302-449-3030
Practice Address - Fax:302-449-3040
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0001000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE420548ZB9MOtherMEDICARE PTAN