Provider Demographics
NPI:1457753329
Name:CHAPMAN, BRENDA I
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:CHAPMAN
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 CEDAR AVE
Mailing Address - Street 2:APT 3B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-5512
Mailing Address - Country:US
Mailing Address - Phone:718-365-9108
Mailing Address - Fax:718-365-9108
Practice Address - Street 1:2101 CEDAR AVE
Practice Address - Street 2:3B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-5512
Practice Address - Country:US
Practice Address - Phone:718-365-9108
Practice Address - Fax:718-365-9108
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3502431163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse