Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 25MA09494200 | NJ |
NPI | 1043479926 |
---|---|
Provider Name | Dr. Charlesse Pondt Huannou |
First Address | Boston, MA 02241-6457 |
Second Address | Springfield, NJ 07081-1151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2008 |
Last Update Date | 11/12/2020 |