Provider Demographics
NPI:1407429178
Name:JEAN-CHARLES, ORLANDO (MSN, RN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:JEAN-CHARLES
Suffix:
Gender:M
Credentials:MSN, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GIFFORD PL
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1608
Mailing Address - Country:US
Mailing Address - Phone:862-223-9142
Mailing Address - Fax:
Practice Address - Street 1:17 GIFFORD PL
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1608
Practice Address - Country:US
Practice Address - Phone:862-223-9142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01165800363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health