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Individual

MELISSA A CHARLEBOIS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RPA C

Contact information

Practice address
826 WASHINGTON ST, SUITE 204, WATERTOWN, NY 13601-4063
(315) 788-1751
(315) 788-9021
Mailing address
826 WASHINGTON ST, SUITE 204, WATERTOWN, NY 13601-4063
(315) 788-1751
(315) 788-9021

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0102671
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02634577
NY
Enumeration date
09/22/2005
Last updated
07/08/2007
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