Healthcare Provider Details

I. General information

NPI: 1073990073
Provider Name (Legal Business Name): CHARITY ENWERE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18719 LINDEN BLVD
SAINT ALBANS NY
11412-4025
US

IV. Provider business mailing address

938 DERRICK ADKINS LN
WEST HEMPSTEAD NY
11552-3914
US

V. Phone/Fax

Practice location:
  • Phone: 718-276-1100
  • Fax:
Mailing address:
  • Phone: 646-645-5440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number558563
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number307765
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: