Individual
ALICIA CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7108
Mailing address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7108
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/02/2022
Last updated
12/02/2022
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