Individual
CHARLENE BREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 257-2188
Mailing address
10 GRAHAM RD W, ITHACA, NY 14850-1055
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/14/2022
Last updated
01/24/2025
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