Provider Demographics
NPI:1598555997
Name:CHAMELI, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CHAMELI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 LAPP RD
Mailing Address - Street 2:
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-9685
Mailing Address - Country:US
Mailing Address - Phone:716-984-6138
Mailing Address - Fax:
Practice Address - Street 1:9555 LAPP RD
Practice Address - Street 2:
Practice Address - City:CLARENCE CENTER
Practice Address - State:NY
Practice Address - Zip Code:14032-9685
Practice Address - Country:US
Practice Address - Phone:716-984-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program