Individual
CHARLES JAMES BRISCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
3375 PARK AVE, WANTAGH, NY 11793-3733
(516) 781-1911
(516) 781-1173
Mailing address
3375 PARK AVE, WANTAGH, NY 11793-3733
(516) 781-1911
(516) 781-1173
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089653-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03003069
—
NY
Enumeration date
11/27/2013
Last updated
12/12/2013
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