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General NPI Number Information
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NPI Number | 1982631198
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Entity Type | Individual
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Provider Name | CHARLOTTE LYNN CREECH MD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 400 WESTAGE BUSINESS CTR DR STE 210
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City | FISHKILL
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State | NY
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Zip | 12524-2266
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Country | US
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Telephone | 845-838-8474
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Fax |
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Provider Business Mailing Address
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Address Line | 243 NORTH RD STE 304
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City | POUGHKEEPSIE
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State | NY
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Zip | 12601-1173
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Country | US
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Telephone | 845-471-9410
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Fax | 845-845-7233
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 219459
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License Number State | NY
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