Provider Demographics
NPI:1144382052
Name:ASTROVE, CHARLES STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:STEPHEN
Last Name:ASTROVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OLD TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2532
Mailing Address - Country:US
Mailing Address - Phone:845-627-2848
Mailing Address - Fax:845-627-6638
Practice Address - Street 1:20 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2532
Practice Address - Country:US
Practice Address - Phone:845-627-2848
Practice Address - Fax:845-627-6638
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0988842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
072570OtherVALUE OPTIONS MHS
0012648OtherGHI
NY00524456Medicaid
072570OtherVALUE OPTIONS MHS
B16699Medicare UPIN