Provider Demographics
NPI:1497303051
Name:MIGLIARO, CHARLENE
Entity Type:Individual
Prefix:PROF
First Name:CHARLENE
Middle Name:
Last Name:MIGLIARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 SPRUCEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-3838
Mailing Address - Country:US
Mailing Address - Phone:516-735-1345
Mailing Address - Fax:
Practice Address - Street 1:172 SPRUCEWOOD DR
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-3838
Practice Address - Country:US
Practice Address - Phone:516-735-1345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst