Provider Demographics
NPI:1942655212
Name:TRICIA CHAMBERS REGISTERED NURSE ANESTHETIST PC
Entity Type:Organization
Organization Name:TRICIA CHAMBERS REGISTERED NURSE ANESTHETIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:917-816-7267
Mailing Address - Street 1:11402 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3117
Mailing Address - Country:US
Mailing Address - Phone:917-816-7267
Mailing Address - Fax:347-809-4399
Practice Address - Street 1:130 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8066
Practice Address - Country:US
Practice Address - Phone:917-816-7267
Practice Address - Fax:347-809-4399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty