Provider Demographics
NPI:1114285343
Name:CHARLAND WOMENS MEDICAL HEALTHCARE PLLC
Entity Type:Organization
Organization Name:CHARLAND WOMENS MEDICAL HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-842-0373
Mailing Address - Street 1:199 HICKORY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-6419
Mailing Address - Country:US
Mailing Address - Phone:518-842-0373
Mailing Address - Fax:518-842-0135
Practice Address - Street 1:446 GUY PARK AVE
Practice Address - Street 2:SUITE A
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-1005
Practice Address - Country:US
Practice Address - Phone:518-842-0373
Practice Address - Fax:518-842-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty