Provider Demographics
NPI:1356120612
Name:CHARLOT, AGLAE M (MD)
Entity type:Individual
Prefix:
First Name:AGLAE
Middle Name:M
Last Name:CHARLOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AGLAE
Other - Middle Name:
Other - Last Name:CHARLOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:213 E 26TH ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1955
Mailing Address - Country:US
Mailing Address - Phone:646-279-4976
Mailing Address - Fax:
Practice Address - Street 1:351 E RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4819
Practice Address - Country:US
Practice Address - Phone:201-646-2940
Practice Address - Fax:201-646-2950
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10520100207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic PathologyGroup - Single Specialty