Provider Demographics
NPI:1326402967
Name:IDLER, CHARLES JAMES (EDD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JAMES
Last Name:IDLER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 FRANKLIN CIR
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-3002
Mailing Address - Country:US
Mailing Address - Phone:609-417-7745
Mailing Address - Fax:
Practice Address - Street 1:9 FRANKLIN CIR
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-3002
Practice Address - Country:US
Practice Address - Phone:609-417-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-10
Last Update Date:2016-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor