Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | X009333-1 | NY |
NPI | 1881713634 |
---|---|
Provider Name | Dr. Pamela Ann Charles |
First Address | New York, NY 10128-1180 |
Second Address | New York, NY 10128-1180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 06/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U80063 | (02) | NY |