Provider Demographics
NPI:1922377928
Name:CHARLEMAGNE, SYNDIE N (LPN)
Entity Type:Individual
Prefix:
First Name:SYNDIE
Middle Name:N
Last Name:CHARLEMAGNE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 KENNEDY DR APT F8
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5389
Mailing Address - Country:US
Mailing Address - Phone:845-521-0284
Mailing Address - Fax:
Practice Address - Street 1:101 KENNEDY DRIVE APT F8
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977
Practice Address - Country:US
Practice Address - Phone:845-521-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287639253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care