Individual
DR. CHARLES EUGENE MOON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4678
(718) 515-5416
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4678
(718) 515-5416
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
321928
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2020
Last updated
10/28/2023
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