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Individual

CHARLES GEORGE DRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
161 FORT WASHINGTON AVE, NEW YORK, NY 10032-3729
(212) 305-5098
Mailing address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-5098

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
D59039
MD
207RX0202X
Medical Oncology Physician
Primary
287243
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
401519300
MD
Enumeration date
05/27/2006
Last updated
02/08/2017
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