Individual
CHARLES DEGAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
66 SUMMER ST, APT. 7K, BUFFALO, NY 14209-2229
(585) 576-3577
Mailing address
66 SUMMER ST, APT. 7K, BUFFALO, NY 14209-2229
(585) 576-3577
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
301695
NY
Other
Enumeration date
07/17/2010
Last updated
07/17/2010
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