Healthcare Provider Details

I. General information

NPI: 1376830786
Provider Name (Legal Business Name): ANNE CHARADIN-NOEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 WASHINGTON AVE
SUFFERN NY
10901-6026
US

IV. Provider business mailing address

1 MALLORY RD
SPRING VALLEY NY
10977-3116
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-4500
  • Fax:
Mailing address:
  • Phone: 845-425-4448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number580801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: