Provider Demographics
NPI:1760634976
Name:CHARLES, NAVINA LYDIA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:NAVINA
Middle Name:LYDIA
Last Name:CHARLES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 ALTA AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-1413
Mailing Address - Country:US
Mailing Address - Phone:914-457-4458
Mailing Address - Fax:
Practice Address - Street 1:138 ALTA AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-1413
Practice Address - Country:US
Practice Address - Phone:914-457-4458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12840800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse