Provider Demographics
NPI:1740542687
Name:CHARLETON-HENRY, HOLLY HENRIETTA (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:HENRIETTA
Last Name:CHARLETON-HENRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:304 E 156TH ST
Mailing Address - Street 2:APT 2G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4851
Mailing Address - Country:US
Mailing Address - Phone:347-524-5269
Mailing Address - Fax:
Practice Address - Street 1:900 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2145
Practice Address - Country:US
Practice Address - Phone:516-256-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY265462207P00000X
NJ25MA09470200207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine