Provider Demographics
NPI:1194939348
Name:CHROME, FAMOUS (L AC)
Entity type:Individual
Prefix:
First Name:FAMOUS
Middle Name:
Last Name:CHROME
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:FAMOUS
Other - Middle Name:
Other - Last Name:CHROME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:110 NEW YORK AVE APT 3G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3485
Mailing Address - Country:US
Mailing Address - Phone:646-724-1583
Mailing Address - Fax:
Practice Address - Street 1:110 NEW YORK AVE APT 3G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3485
Practice Address - Country:US
Practice Address - Phone:646-724-1583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003314171100000X
NY3314-01171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist