Bagley, Charles H

Bagley, Charles H is an individual health care provider with primary practice located at 21814 Northern Blvd 101, Bayside NY 11361-3581. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Bagley, Charles H can be contacted via phone (718) 229-4868.

Contact Information

Primary practice address
21814 Northern Blvd 101 Bayside NY 11361-3581
Phone: (718) 229-4868
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 132024 New York

Profile Details

NPI number 1568496115
LBN Legal business name Bagley, Charles H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated May 1st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568496115 NPPES
New York Other 132024 NYS LICENSE
New York MEDICAID 01015892 NYS LICENSE

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