Provider Demographics
NPI:1972534865
Name:ALLEYNE, CHARMAINE GRACELYN (NP)
Entity Type:Individual
Prefix:MS
First Name:CHARMAINE
Middle Name:GRACELYN
Last Name:ALLEYNE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BENCHLEY PL
Mailing Address - Street 2:APT 27D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3302
Mailing Address - Country:US
Mailing Address - Phone:917-306-4705
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420838363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology