Healthcare Provider Details

I. General information

NPI: 1831416221
Provider Name (Legal Business Name): CHARLES L MADEIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 E 23RD ST
NEW YORK NY
10010-5011
US

IV. Provider business mailing address

423 E 23RD ST
NEW YORK NY
10010-5011
US

V. Phone/Fax

Practice location:
  • Phone: 212-987-3100
  • Fax: 212-731-5210
Mailing address:
  • Phone: 212-987-3100
  • Fax: 212-731-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number264593
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: