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Individual

LOURDESSE CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
620 E 13TH ST, NEW YORK, NY 10009-1553
(908) 906-0395
Mailing address
325 FERNWOOD TER, LINDEN, NJ 07036-5211
(908) 906-0395

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
790259-01
NY

Other

Enumeration date
07/31/2008
Last updated
06/16/2025
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