Provider Demographics
NPI:1326139072
Name:MESSINA, CHARLES I (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:I
Last Name:MESSINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:149 M HIGHWAY 31
Mailing Address - Street 2:THE DOCTOR IS IN, PA
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-782-7700
Mailing Address - Fax:908-782-3644
Practice Address - Street 1:59 OLD ROUTE 22
Practice Address - Street 2:THE DOCTOR IS IN, PA
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809
Practice Address - Country:US
Practice Address - Phone:908-730-6363
Practice Address - Fax:908-730-8185
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2009-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA28967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53404Medicare UPIN
NJ125519Medicare ID - Type Unspecified