Individual
MARIE LINE CHARLOTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
855 WESLEY ST, NORTH BALDWIN, NY 11510-1433
(516) 546-9227
(516) 546-9227
Mailing address
855 WESLEY ST, NORTH BALDWIN, NY 11510-1433
(516) 546-9227
(516) 546-9227
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
004546-1
NY
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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