Provider Demographics
NPI:1669895421
Name:DOYLEY, CHANTELLEE (MSED)
Entity type:Individual
Prefix:
First Name:CHANTELLEE
Middle Name:
Last Name:DOYLEY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33-16 102ND STREET
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368
Mailing Address - Country:US
Mailing Address - Phone:347-447-6535
Mailing Address - Fax:
Practice Address - Street 1:3316 102ND ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-1131
Practice Address - Country:US
Practice Address - Phone:347-447-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist