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NPI 1659903581

NPI 1659903581 : CHRISTINE CHARLES, APRN, INC. : FAR ROCKAWAY, NY

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General NPI Number Information
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    NPI Number           |    1659903581
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHRISTINE CHARLES, APRN, INC. 
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Dates
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    Enumeration Date     |    02/09/2020
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    Last Update Date     |    02/09/2020
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Provider Practice Location Address
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    Address Line         |    1428 GRANADA PL 
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    City                 |    FAR ROCKAWAY
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    State                |    NY
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    Zip                  |    11691-1708
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    Country              |    US
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    Telephone            |    718-536-0165
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1428 GRANADA PL 
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    City                 |    FAR ROCKAWAY
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    State                |    NY
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    Zip                  |    11691-1708
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    Country              |    US
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    Telephone            |    718-536-0165
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     CHRISTINE  CHARLES 
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    Credential           |    
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    Telephone            |    718-536-0165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251J00000X
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    Taxonomy Name        |    Nursing Care Agency
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    License Number       |    
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    License Number State |    
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