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Individual

MIREILLE CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1 PENN PLZ, SUITE 725, NEW YORK, NY 10119-0002
(612) 655-5942
Mailing address
985 WOOD PARK DR, NORTH BALDWIN, NY 11510-1235
(516) 208-7094
(516) 208-7094

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F306590
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
F306590
NY

Other

Enumeration date
02/01/2014
Last updated
07/30/2015
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