Individual
MR. DANIEL R CHARLEBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
46520 NORTH RD, SOUTHOLD, NY 11971-5040
(631) 765-9389
(631) 765-9369
Mailing address
201 MANOR PL, GREENPORT, NY 11944-1222
(631) 765-9389
(631) 765-9369
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4399
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00274337
—
NY
Enumeration date
10/09/2009
Last updated
10/09/2009
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