Individual
DR. CHARLES W. EPISALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39 OLD MONTICELLO RD, FERNDALE, NY 12734-5224
(845) 292-4450
(845) 292-4642
Mailing address
30 HATFIELD LN, SUITE 201, GOSHEN, NY 10924-6766
(845) 294-3446
(845) 294-4171
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
184453
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01410035
—
NY
Enumeration date
05/31/2006
Last updated
11/26/2013
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