Provider Demographics
NPI:1952997074
Name:CHEVALIER, MAURICE (NP, RN)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:CHEVALIER
Suffix:
Gender:M
Credentials:NP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252A LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6932
Mailing Address - Country:US
Mailing Address - Phone:347-661-2337
Mailing Address - Fax:718-980-5267
Practice Address - Street 1:252A LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6932
Practice Address - Country:US
Practice Address - Phone:347-661-2337
Practice Address - Fax:718-980-5267
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRN-582808-1163W00000X
NY310105363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology