Individual
SHEILA CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
652 HOOVER ST, EAST MEADOW, NY 11554-5429
(646) 472-9986
Mailing address
16347 130TH AVE, APT 3B, JAMAICA, NY 11434-3081
(646) 472-9986
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F308335
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649523366
—
NY
Enumeration date
10/18/2012
Last updated
05/09/2018
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