Individual ProviderChantale SouffrantRegistered NurseNursing Service ProvidersPractice Address1665 Tillotson Ave, Bronx, NY 10469-2746(718) 671-2100PECOS EnrollmentBased on the most recent information from CMS, provider Chantale Souffrant does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1164799805Provider TypeIndividualFull NameSouffrant, ChantaleCredentialRNGenderFemaleSole ProprietorYesEnumeration Date11/23/2011Last Updated11/23/2011Contact InformationPractice LocationPractice Address1665 Tillotson Ave, Bronx, NY 10469-2746Phone(718) 671-2100FaxUnlisted FaxMailing LocationMailing Address1665 Tillotson Ave, Bronx, NY 10469-2746Phone(718) 671-2100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense633438New York