Healthcare Provider Details

I. General information

NPI: 1114285343
Provider Name (Legal Business Name): CHARLAND WOMENS MEDICAL HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 GUY PARK AVE SUITE A
AMSTERDAM NY
12010-1005
US

IV. Provider business mailing address

199 HICKORY RIDGE RD
AMSTERDAM NY
12010-6419
US

V. Phone/Fax

Practice location:
  • Phone: 518-842-0373
  • Fax: 518-842-0135
Mailing address:
  • Phone: 518-842-0373
  • Fax: 518-842-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number173248
License Number StateNY

VIII. Authorized Official

Name: JAMES M. CHARLAND
Title or Position: M.D./OWNER
Credential: M.D.
Phone: 518-842-0373