Provider Demographics
NPI:1699533166
Name:CAMEAU, CHIRRARD
Entity type:Individual
Prefix:
First Name:CHIRRARD
Middle Name:
Last Name:CAMEAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 BROADWAY APT 3F
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1329
Mailing Address - Country:US
Mailing Address - Phone:516-232-3231
Mailing Address - Fax:
Practice Address - Street 1:1425 BROADWAY APT 3F
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1329
Practice Address - Country:US
Practice Address - Phone:516-232-3231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist