Individual
CHARLENE A IVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
258 HOOSICK ST STE 206, TROY, NY 12180-2450
(518) 272-2097
Mailing address
449 ROUTE 146 STE 101, HALFMOON, NY 12065-3239
(518) 373-3924
(518) 373-3808
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
042-0010450
VT
207RH0003X
Hematology & Oncology Physician
Primary
236239
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02671869
—
NY
05
—
1009057
—
VT
Enumeration date
07/14/2006
Last updated
01/04/2022
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