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General NPI Number Information
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NPI Number | 1174599682
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Entity Type | Individual
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Provider Name | MARISE ST. CHARLES D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 141 S CENTRAL AVE STE 205
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City | HARTSDALE
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State | NY
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Zip | 10530-2340
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Country | US
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Telephone | 914-793-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 141 S CENTRAL AVE STE 205
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City | HARTSDALE
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State | NY
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Zip | 10530-2340
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Country | US
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Telephone | 914-793-5588
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 257178
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License Number State | NY
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