Individual
JEAN CLAUDE CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
68 BELMONT AVE, BROOKLYN, NY 11212-6705
(718) 484-8056
(718) 484-8325
Mailing address
12930 135TH ST, SOUTH OZONE PARK, NY 11420-3542
(347) 522-7547
(347) 789-5533
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
199884
NY
208000000X
Pediatrics Physician
Primary
199884
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01598874
—
NY
01
—
199884
LICENSE
NY
Enumeration date
07/03/2005
Last updated
04/09/2021
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