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Individual

MR. CHARLES BENJAMIN NGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
200 RETREAT AVE, HARTFORD, CT 06102-3101
(860) 545-7295
Mailing address
332 HAWK VALLEY DR, TRAVELERS REST, SC 29690-7307
(714) 277-7886

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10.218533
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
013347
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2024028681
AACN
Enumeration date
03/28/2024
Last updated
08/06/2024
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