Individual
CHARLES SEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
59 SCHOOL STREET, MALVERNE, NY 11565
(516) 599-2077
Mailing address
59 SCHOOL STREET, MALVERNE, NY 11565
(917) 748-3013
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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