Provider Demographics
NPI:1336286004
Name:CHARNEY, COLLEEN (MD)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:CHARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 OSTRUM STREET
Mailing Address - Street 2:CVO ENTOLLMENTS
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6048
Mailing Address - Fax:833-213-6428
Practice Address - Street 1:1251 TURNSTONE DR STE 120
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-1713
Practice Address - Country:US
Practice Address - Phone:610-336-4676
Practice Address - Fax:833-221-0341
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2020-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD073516L207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H51215Medicare UPIN