Provider Demographics
NPI:1528354594
Name:KIN, CHAYA ROCHEL (RN)
Entity type:Individual
Prefix:
First Name:CHAYA
Middle Name:ROCHEL
Last Name:KIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GREEN HILL LN
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1608
Mailing Address - Country:US
Mailing Address - Phone:845-461-4426
Mailing Address - Fax:845-354-3546
Practice Address - Street 1:20514 LINDEN BLVD STE 204
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-2934
Practice Address - Country:US
Practice Address - Phone:718-528-5493
Practice Address - Fax:718-525-4305
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY632629163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse