Brazeau, Chantal
Brazeau, Chantal is an individual health care provider with primary practice located at 90 Bergen St Lower Level Suite 300, Newark NJ 07103-2425. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Brazeau, Chantal can be contacted via phone (973) 972-2111.Contact Information
Primary practice address
90 Bergen St Lower Level Suite 300
Newark NJ 07103-2425
Phone: (973) 972-2111
Fax: (973) 972-2754
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 25MA04667000 | New Jersey |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25MA04667000 | New Jersey |
Profile Details
| NPI number | 1780796193 |
|---|---|
| LBN Legal business name | Brazeau, Chantal |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Feb 2nd, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780796193 | NPPES |
| New Jersey | MEDICAID | 1582305 |
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