Provider Demographics
NPI:1821249715
Name:CHARLES H DEBROVNER, M.D., P.C
Entity Type:Organization
Organization Name:CHARLES H DEBROVNER, M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SELICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-683-0090
Mailing Address - Street 1:338 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8318
Mailing Address - Country:US
Mailing Address - Phone:212-683-0090
Mailing Address - Fax:212-689-3699
Practice Address - Street 1:338 E 30TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8318
Practice Address - Country:US
Practice Address - Phone:212-683-0090
Practice Address - Fax:212-689-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty