Individual
MR. CHARLES C LIVOTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
502 SOUTH WELLWOOD AVENUE, LINDENHURST, NY 11757
(631) 226-8600
(631) 957-7858
Mailing address
502 SOUTH WELLWOOD AVENUE, LINDENHURST, NY 11757
(631) 226-8600
(631) 957-7858
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
206207
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01919433
—
NY
Enumeration date
12/13/2005
Last updated
12/06/2011
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