Provider Demographics
NPI:1073572236
Name:RHEEMAN, CHARLES H (MD)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:H
Last Name:RHEEMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:658 MALTA AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020
Mailing Address - Country:US
Mailing Address - Phone:518-580-0553
Mailing Address - Fax:518-580-0557
Practice Address - Street 1:658 MALTA AVE
Practice Address - Street 2:STE 101
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020
Practice Address - Country:US
Practice Address - Phone:518-580-0553
Practice Address - Fax:518-580-0557
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2023-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY207362207W00000X
NY207362-01207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03425445Medicaid
NY01948654Medicaid
NY0818600001Medicare NSC