Provider Demographics
NPI:1275349359
Name:CHI, ELAINE MANLI (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:MANLI
Last Name:CHI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5523
Mailing Address - Country:US
Mailing Address - Phone:617-423-0590
Mailing Address - Fax:617-770-1004
Practice Address - Street 1:288 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5523
Practice Address - Country:US
Practice Address - Phone:617-423-0590
Practice Address - Fax:617-770-1004
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN205002163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse