Provider Demographics
NPI:1417034679
Name:RINN, CHARLES F JR (PNP)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:F
Last Name:RINN
Suffix:JR
Gender:M
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 IRVING AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1529
Mailing Address - Country:US
Mailing Address - Phone:315-436-4667
Mailing Address - Fax:315-471-1762
Practice Address - Street 1:475 IRVING AVE STE 210
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1529
Practice Address - Country:US
Practice Address - Phone:315-471-2646
Practice Address - Fax:315-471-1762
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381335363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics