Individual
CHARLENE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14520 176TH ST, JAMAICA, NY 11434-4916
(347) 841-4164
Mailing address
14520 176TH ST, JAMAICA, NY 11434-4916
(347) 841-4164
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
312681
NY
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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