MEDICARE: MIMOSE CHARLES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LS0200X	School Nurse Practitioner	502800-1	NY

General Provider Information

NPI Number	:	1225731953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIMOSE CHARLES

Provider Business Mailing Address
First Line	:	666 E 88TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-3402
Country	:	US
Telephone Number	:	347-432-5294
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3825
Country	:	US
Telephone Number	:	718-272-2946
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2023
Last Update Date	:	03/22/2023

Similar Medicare Providers

1720894959 — JOELLE ROSE SAADEH
Practice Location Address:

5101 AVENUE M
BROOKLYN, NY
11234-3825

Practice Phone: 929-565-4963
Practice Fax:

1528271038 — RXMK CORPORATION
Practice Location Address:

210 AVENUE U
BROOKLYN, NY
11223-3825

Practice Phone: 718-373-4100
Practice Fax: 718-373-4114

1376794396 — ARMS OF COMPASSION HOME CARE SERVICE
Practice Location Address:

3825 51ST AVE N
BROOKLYN CENTER, MN
55429-3368

Practice Phone: 612-408-8433
Practice Fax: 612-659-1499

1013249432 — MARK KHASKELZON B.S. PHARM
Practice Location Address:

210 AVENUE U , WESTSIDE PHARMACY
BROOKLYN, NY
11223-3825

Practice Phone: 718-373-4100
Practice Fax: 718-373-4114

1306178553 — MS. ULYANA DOMSKA PHARMD
Practice Location Address:

210 AVENUE U
BROOKLYN, NY
11223-3825

Practice Phone: 718-373-4100
Practice Fax:

1497079826 — MRS. MIRA LEVIN PHARMACIST
Practice Location Address:

2617 E 17TH ST
BROOKLYN, NY
11235-3825

Practice Phone: 646-683-7183
Practice Fax: 718-897-2570

Directions to “ MIMOSE CHARLES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.