Individual
CHARLES STAPLES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 SYLVAN LAKE RD, WATERTOWN, CT 06779-1450
(203) 260-8744
Mailing address
205 SYLVAN LAKE RD, WATERTOWN, CT 06779-1450
(203) 260-8744
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F1015603
CT
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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