Organization
CHRISTAL D CHARBONNET, DPM P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTAL CHARBONNET DPM (PROVIDER/OWNER)
(504) 460-0987
Entity
Organization
Contact information
Practice address
4243 RICHMOND AVE, 1ST FLOOR, STATEN ISLAND, NY 10312-6221
(504) 460-0987
Mailing address
PO BOX 15616, NEW ORLEANS, LA 70175-5616
(504) 460-0987
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N006465
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03468971
—
NY
01
—
A300068955
MEDICARE PTAN
—
Enumeration date
07/15/2015
Last updated
07/15/2015
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