Basic Information
| Provider Information | |||||||||
| NPI: | 1417273756 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHARNEY | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | LICENSED RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1002 ROUTE 211 W | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109407637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453862999 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 45 ASHLEY AVE BLDG 57 | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109401912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453436686 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2010 | ||||||||
| LastUpdateDate: | 04/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 415266 | NY | Y | Hospital Units | Psychiatric Unit |
No ID Information.