Provider Demographics
NPI:1336437425
Name:PUNSKI, CHARLOTTE REBECCA (RN,PA)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:REBECCA
Last Name:PUNSKI
Suffix:
Gender:F
Credentials:RN,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
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Mailing Address - Street 1:3901 INDEPENDENCE AVE APT 6H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1226
Mailing Address - Country:US
Mailing Address - Phone:718-601-4296
Mailing Address - Fax:
Practice Address - Street 1:3901 INDEPENDENCE AVE APT 6H
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1226
Practice Address - Country:US
Practice Address - Phone:718-601-4296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000663363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant