Provider Demographics
NPI:1073107314
Name:CHARLES H. THORNE MD PLLC
Entity Type:Organization
Organization Name:CHARLES H. THORNE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-794-0044
Mailing Address - Street 1:812 PARK AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2770
Mailing Address - Country:US
Mailing Address - Phone:212-794-0044
Mailing Address - Fax:212-772-1326
Practice Address - Street 1:812 PARK AVE APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2770
Practice Address - Country:US
Practice Address - Phone:212-794-0044
Practice Address - Fax:212-772-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-26
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty