Individual
MR. CHARLES WILLIAM BOLD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
125 LYNBROOK DRIVE, SOUND BEACH, NY 11789-1722
(631) 842-2946
Mailing address
125 LYNBROOK DRIVE, SOUND BEACH, NY 11789-1722
(631) 842-2946
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
595601 1
NY
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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