Provider Demographics
NPI:1932825536
Name:CHAHADE, ERICA R (LMT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:R
Last Name:CHAHADE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 FAIRWAYS CRESCENT COURT
Mailing Address - Street 2:
Mailing Address - City:CAMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-5411
Mailing Address - Country:US
Mailing Address - Phone:914-760-6047
Mailing Address - Fax:
Practice Address - Street 1:600 N BROADWAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-2466
Practice Address - Country:US
Practice Address - Phone:914-760-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032611-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty