Katia Charles

Individual provider Active NPI Licensed Practical Nurse · Central Valley, NY

NPI 1861972010 · NPPES record last updated Aug 17, 2018

Key facts

NPI
1861972010
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
297954 (NY)
Practice address
19 Falkirk Ave
Central Valley, NY 10917-3627
Phone
(718) 828-2666
NPI assigned
Aug 17, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
297954NYMDPsychiatry Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 297954 NY Yes

Addresses

Primary practice location

19 Falkirk Ave
Central Valley, NY 10917-3627

Mailing address

19 Falkirk Ave
Central Valley, NY 10917-3627
Phone (718) 828-2666

Other providers in Central Valley, NY

All providers in Central Valley, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.