Provider Demographics
NPI:1508183062
Name:CHARLES, PETER LESLEY JR (RN)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:LESLEY
Last Name:CHARLES
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 GRACE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3201
Mailing Address - Country:US
Mailing Address - Phone:646-703-1342
Mailing Address - Fax:
Practice Address - Street 1:131 GRACE ST FL 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-3201
Practice Address - Country:US
Practice Address - Phone:646-703-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY583215163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse