Individual
CHARLES ROBERT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
194 HAIGHT RD, AMENIA, NY 12501-5234
(845) 373-4100
Mailing address
WEBUTUCK SCHOOL BASED HEALTH CENTER, 194 HAIGHT ROAD, AMENIA, NY 12524
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F345256-01
NY
Other
Enumeration date
04/12/2022
Last updated
04/12/2022
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