Individual
MRS. CEONEAH CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13015 225TH ST, LAURELTON, NY 11413-1228
(212) 867-6530
(212) 867-6535
Mailing address
13015 225TH ST, LAURELTON, NY 11413-1228
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
210342-1
NY
Other
Enumeration date
08/06/2008
Last updated
08/06/2008
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