Individual
CHARLES MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
425 ROBINSON ST, BINGHAMTON, NY 13904-1735
(607) 724-1391
Mailing address
425 ROBINSON ST, BINGHAMTON, NY 13904-1735
(607) 724-1391
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
497645
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
497645
NURSING LICENSE
NY
Enumeration date
04/05/2018
Last updated
04/05/2018
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