Provider Demographics
NPI:1508125279
Name:CHARLES-EMMANUEL, LOVELYNE M (MSED)
Entity Type:Individual
Prefix:MRS
First Name:LOVELYNE
Middle Name:M
Last Name:CHARLES-EMMANUEL
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 E 94TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5224
Mailing Address - Country:US
Mailing Address - Phone:646-541-0793
Mailing Address - Fax:
Practice Address - Street 1:1628 E 94TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5224
Practice Address - Country:US
Practice Address - Phone:646-541-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist