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Individual

MRS. CHARLEEN THERESE HOLDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11520 217TH ST, CAMBRIA HEIGHTS, CAMBRIA HEIGHTS, NY 11411-1116
(347) 420-4109
Mailing address
11520 217TH ST, CAMBRIA HEIGHTS, CAMBRIA HEIGHTS, NY 11411-1116
(347) 420-4109

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F351140
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
664418
RN LICENSE
NY
Enumeration date
10/15/2012
Last updated
09/23/2025
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