Provider Demographics
NPI:1629011333
Name:CHARLES, MARLENE (MD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:CHARLES
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Gender:F
Credentials:MD
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Mailing Address - Street 1:451 CLARKSON AVE
Mailing Address - Street 2:R BUILDING 4TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:718-245-5052
Mailing Address - Fax:718-245-4062
Practice Address - Street 1:451 CLARKSON AVE
Practice Address - Street 2:KINGS COUNTY HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-5052
Practice Address - Fax:718-382-5905
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2013-03-19
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Provider Licenses
StateLicense IDTaxonomies
NY2128942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH25072Medicare UPIN