Healthcare Provider Details

I. General information

NPI: 1225630429
Provider Name (Legal Business Name): CVA CHARNWOOD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 BOOTH DR
PLATTSBURGH NY
12901-6404
US

IV. Provider business mailing address

14 BOOTH DR
PLATTSBURGH NY
12901-6404
US

V. Phone/Fax

Practice location:
  • Phone: 518-324-5707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: MR. DARREN XU
Title or Position: OWNER
Credential: AU.D.
Phone: 518-324-5707