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General NPI Number Information
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NPI Number | 1629011333
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Entity Type | Individual
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Provider Name | MARLENE CHARLES M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 451 CLARKSON AVE KINGS COUNTY HOSPITAL
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City | BROOKLYN
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State | NY
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Zip | 11203
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Country | US
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Telephone | 718-245-5052
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Fax | 718-382-5905
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Provider Business Mailing Address
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Address Line | 451 CLARKSON AVE R BUILDING 4TH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11203
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Country | US
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Telephone | 718-245-5052
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Fax | 718-245-4062
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 212894
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License Number State | NY
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