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Individual

CHARLES MCGUIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1540 MAPLE RD, WILLIAMSVILLE, NY 14221-3647
(716) 878-7662
Mailing address
908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
F350041
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02023105
NY
Enumeration date
03/14/2006
Last updated
07/08/2007
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