DR. CHARLES NELSON PROCTOR IV (NPI# 1700376092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700376092 |
| Entity Type | Individual |
| Full Name | DR. CHARLES NELSON PROCTOR IV |
| Credential | MD |
| Practice Address |
300 2nd Ave Long Branch NJ 07740-6303 |
| Mailing Address |
20 Estemerwalt Dr Hawley PA 18428-3032 |
| Practice Telephone | 7322225200 |
| Mailing Telephone | 6508629942 |
| Enumeration Date | 2018-05-13 |
| Last Update Date | 2018-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740418359 | Charles Medlock Proctor | Ophthalmology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2009-06-23 |
| Street Address |
300 2ND AVE |
| City | LONG BRANCH |
| State | NJ |
| Zip Code | 07740-6303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346246048 | Kathleen L Mcdonald | Radiology | 300 2nd Ave, Long Branch, NJ 07740-6303 | 2005-06-27 |
| 1992302798 | Shannon Margaret Kirk | Nurse Practitioner | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-10-05 |
| 1487267241 | Poonam Raut | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-30 |
| 1356952261 | Arundhati Chandini Arjun | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-13 |
| 1811507395 | Charmee Hitesh Vyas | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-09 |
| 1235749839 | Tiwadayo Sam-odusina | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-07 |
| 1740890508 | Rama Maghnam | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-06 |
| 1831708239 | Kimberly Lily Pereira | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-07-31 |
| 1407465818 | Niharika Podaralla | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-07-31 |
| 1003425505 | Michelle Woodfield | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043789563 | Lauryn Elaine Balestiero | Social Worker | 75 North Bath Avenue, Long Branch, NJ 07740 | 2018-11-14 |
| 1063991768 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 96 Church St. Apt. 317, Aberdeen, NJ 07740 | 2018-08-13 |
| 1649765785 | Tatiana Nuzum | Student in an Organized Health Care Education/Training Program | 300 2nd Ave # Sw209, Long Branch, NJ 07740 | 2018-06-29 |
| 1558862466 | Melissa Gagliardi | Social Worker | 274 Bath Avenue, Unit 9, Long Branch, NJ 07740 | 2018-02-26 |
| 1871966879 | Caringhouse Projects, Inc | Respite Care | 218 Highland Avenue, Long Branch, NJ 07740 | 2015-11-12 |
| 1083096556 | Universal Rehabilitation & Fitness Center Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 73a Dudley St., Long Branch, NJ 07740 | 2015-06-22 |
| 1629450101 | Jonathan Kristan | Ophthalmology | 279 3rd Ave Ste 204, Long Branch, NJ 07740 | 2015-06-22 |
| 1730510769 | Elizabeth Worth | Registered Nurse | 63dunbar Ave, Long Branch, NJ 07740 | 2013-12-02 |
| 1710231022 | Pasquale Evangelista | Radiology | 300 2nd Ave., Department of Radiology, Long Branch, NJ 07740 | 2012-11-08 |
| 1326314162 | John Way Chin | Pharmacy | 134 Brighton Avenue, Long Branch, NJ 07740 | 2012-03-27 |
| Find all providers in zip 07740 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679068811 | Shilpa Telang | Student in an Organized Health Care Education/Training Program | 300 2nd Ave # 209, Long Branch, NJ 07740-6395 | 2018-06-29 |
| 1003301151 | Qais Alloah | Student in an Organized Health Care Education/Training Program | 300 2nd Ave Apt 6, Long Branch, NJ 07740-6395 | 2018-06-29 |
| 1649765785 | Tatiana Nuzum | Student in an Organized Health Care Education/Training Program | 300 2nd Ave # Sw209, Long Branch, NJ 07740 | 2018-06-29 |
| 1174018212 | Arnav Vasudeva | Student in an Organized Health Care Education/Training Program | 300 2nd Ave Rm 215sw, Long Branch, NJ 07740-6395 | 2018-06-29 |
| 1437644267 | Juan Manuel Rojas | Student in an Organized Health Care Education/Training Program | Monmouth Medical Center, 300 Second Avenue, Long Branch, NJ 07740-6303 | 2018-06-25 |
| 1891958351 | Cole Fredrick Paul Mendenhall | Student in an Organized Health Care Education/Training Program | 50 Dunbar Ave, Apt B, Long Branch, NJ 07740-6406 | 2008-07-04 |
| 1487267241 | Poonam Raut | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-30 |
| 1356952261 | Arundhati Chandini Arjun | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-13 |
| 1811507395 | Charmee Hitesh Vyas | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-09 |
| 1235749839 | Tiwadayo Sam-odusina | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6395 | 2020-08-07 |
| Find all providers in LONG BRANCH | ||||
| City | LONG BRANCH |
| Zip Code | 07740 |
Please comment or provide details below to improve the information on DR. CHARLES NELSON PROCTOR IV.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.