Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 307112 | NY |
NPI | 1023293479 |
---|---|
Provider Name | Tamara Charles |
First Address | Brooklyn, NY 11219-2916 |
Second Address | Brooklyn, NY 11219-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2008 |
Last Update Date | 02/10/2017 |