Individual
CHARLES H L'HOMMEDIEU JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 CHESTNUT AVE, FARMINGVILLE, NY 11738-1709
(631) 774-0747
Mailing address
24 CHESTNUT AVE, FARMINGVILLE, NY 11738-1709
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
391345
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402795
NY
Other
Enumeration date
03/01/2019
Last updated
03/11/2020
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