Provider Demographics
NPI:1952034282
Name:CHAVEZ, CAMILLE-ASHLEY ZABAT (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:CAMILLE-ASHLEY
Middle Name:ZABAT
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 47TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-1746
Mailing Address - Country:US
Mailing Address - Phone:347-445-5098
Mailing Address - Fax:
Practice Address - Street 1:1150 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5913
Practice Address - Country:US
Practice Address - Phone:212-933-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant