Individual
LARRY S CHARLAMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5112 W TAFT RD STE J, LIVERPOOL, NY 13088-4866
(315) 701-2170
(315) 701-2185
Mailing address
510 TOWNE DR, FAYETTEVILLE, NY 13066-1331
(315) 663-0500
(315) 663-0514
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
179424
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01559282
—
NY
Enumeration date
07/11/2005
Last updated
09/26/2019
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