Provider Demographics
NPI:1508924432
Name:NEU, CHARLES H (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:H
Last Name:NEU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 NEW DORP LANE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3005
Mailing Address - Country:US
Mailing Address - Phone:718-351-3006
Mailing Address - Fax:718-351-3511
Practice Address - Street 1:295 NEW DORP LANE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3005
Practice Address - Country:US
Practice Address - Phone:718-351-3006
Practice Address - Fax:718-351-3511
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV00028471152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1C7786OtherHEALTH NET
NYP835128OtherOXFORD
NY00329451Medicaid
T81427Medicare UPIN
NY0414460001Medicare NSC
1C7786OtherHEALTH NET