Individual
CHARLENE WALDRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1344 E 104TH ST, BROOKLYN, NY 11236-4508
(347) 575-0178
Mailing address
1344 E 104TH ST, BROOKLYN, NY 11236-4508
(347) 575-0178
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
757377-1
NY
Other
Enumeration date
12/24/2019
Last updated
12/24/2019
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