Individual
CHARLES WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(732) 445-4636
Mailing address
50 PINE ST APT 5E, MONTCLAIR, NJ 07042-4700
(337) 849-3868
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA12522700
NJ
Other
Enumeration date
03/22/2022
Last updated
06/25/2025
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