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NPI Code Detail

MEDICARE: CHARLES EVAN LAFARGUE MD

MEDICARE: CHARLES EVAN LAFARGUE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1265376636
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES EVAN LAFARGUE MD
Provider Business Mailing Address
First Line : 16 CEDAR RD
Second Line :
City : WESTBURY
State : NY
Zip : 11590-2728
Country : US
Telephone Number : 516-297-8119
Fax Number :
Provider Business Practice Location Address
First Line : 259 1ST ST
Second Line :
City : MINEOLA
State : NY
Zip : 11501-3957
Country : US
Telephone Number : 516-663-0333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2026
Last Update Date : 04/16/2026

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Directions to “ CHARLES EVAN LAFARGUE MD” Practice Location

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