Individual
DR. CHILDEBERT ST LOUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
873 ROUTE 45 STE 102, NEW CITY, NY 10956-1123
(845) 375-0685
(845) 503-2363
Mailing address
873 ROUTE 45 STE 102, NEW CITY, NY 10956-1123
(845) 375-0685
(845) 503-2363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
65603608
NY
208M00000X
Hospitalist Physician
250239
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03040640
—
NY
Enumeration date
06/20/2008
Last updated
04/30/2020
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