Provider Demographics
NPI:1497833735
Name:CARTWRIGHT, CHARLES NORRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:NORRIS
Last Name:CARTWRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17 ESSEX AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4123
Mailing Address - Country:US
Mailing Address - Phone:973-972-5512
Mailing Address - Fax:973-972-0812
Practice Address - Street 1:183 SOUTH ORANGE AVENUE
Practice Address - Street 2:BHSB F LEVEL
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-972-5512
Practice Address - Fax:973-972-0812
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA070634002084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G64180Medicare UPIN