Individual
DR. CHARLES A. FUNDARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1850-82 ST., SUITE L-2, BROOKLYN, NY 11214-2264
(718) 236-6177
(718) 236-6178
Mailing address
1850-82 ST., SUITE L-2, BROOKLYN, NY 11214-2264
(718) 236-6177
(718) 236-6178
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X003524-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X003524-1
NYS WORKER'S COMPENSATION
NY
Enumeration date
02/22/2007
Last updated
07/08/2007
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