Provider Demographics
NPI:1023262938
Name:CHARLES, DENISE ANN-MARIE (LPN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN-MARIE
Last Name:CHARLES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4132 WILDER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2132
Mailing Address - Country:US
Mailing Address - Phone:718-772-4578
Mailing Address - Fax:
Practice Address - Street 1:9 WEST PROSPECT AVE, SUITE 310
Practice Address - Street 2:ABSOLUTE HOME HEALTH CARE, INC.
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-699-2154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279996-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse