Provider Demographics
NPI:1952601999
Name:CHARLES, FRANK (RN)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:CHARLES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 E CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:NY
Mailing Address - Zip Code:11575-1108
Mailing Address - Country:US
Mailing Address - Phone:516-867-3834
Mailing Address - Fax:516-867-3834
Practice Address - Street 1:113 E CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-1108
Practice Address - Country:US
Practice Address - Phone:516-867-3834
Practice Address - Fax:516-867-3834
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY539332-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse