Individual
MS. DIANE R CHARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
375 PEARL ST, BROOKLYN, NY 11201-3706
(718) 852-1029
Mailing address
375 PEARL ST, BROOKLYN, NY 11201-3706
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
287362-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
287362-1
REGISTERED NURSE
NY
Enumeration date
01/10/2007
Last updated
12/03/2019
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