Provider Demographics
NPI:1649637323
Name:CHALEN, KATHERINE JOAN
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JOAN
Last Name:CHALEN
Suffix:
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 1:2440 BOSTON RD
Mailing Address - Street 2:APPT. 20E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-9036
Mailing Address - Country:US
Mailing Address - Phone:718-304-4393
Mailing Address - Fax:
Practice Address - Street 1:1053 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1048
Practice Address - Country:US
Practice Address - Phone:914-674-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator