Individual
DR. CHARLES PETER HACKETT I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4427 OAK BEACH ASSN, 47 LARBOARD CT., OAK BEACH, NY 11702-4619
(631) 422-1484
(631) 422-9103
Mailing address
4427 OAK BEACH ASSN, 47 LARBOARD CT., OAK BEACH, NY 11702-4619
(631) 422-1484
(631) 422-9103
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
163238
NY
207Q00000X
Family Medicine Physician
Primary
163238
NY
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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