Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 000000 | RI |
NPI | 1174985824 |
---|---|
Provider Name | Chelsea Laber |
First Address | Brewster, NY 10509-2915 |
Second Address | Warwick, RI 02886-2759 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 22/03/2016 |