Individual
CHARLENE ELIZABETH GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
116 VOLNEY ST, PHOENIX, NY 13135-3103
(315) 695-1524
(315) 695-1544
Mailing address
106 COWEN RD, HASTINGS, NY 13076-3178
(315) 668-5110
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
577094
NY
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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