MEDICARE: JOSEPH N CHARLES 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
1	173000000X	Legal Medicine	111981	NY

General Provider Information

NPI Number	:	1457423188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH N CHARLES MD

Provider Business Mailing Address
First Line	:	440 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6706
Country	:	US
Telephone Number	:	718-469-5526
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6706
Country	:	US
Telephone Number	:	718-469-5526
Fax Number	:

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	JOSEPH N CHARLES
Credential	:
Telephone Number	:	718-302-1800

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	08/22/2020

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