MR. CHARLES PATRICK TILLEY NP

Hospice, Inpatient

New York, New York

Provider NPI: 1023346186

Provider Information:
MR. CHARLES PATRICK TILLEY NP


Practice Location:
1250 BROADWAY 7TH FLOOR NEW YORK, NY 10001 US
Tel: 917-763-8716  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	315D00000X	Nursing & Custodial Care Facilities Hospice, Inpatient	NY	305286

Other Provider Identifiers:

Issuer	Number	State	Type
	03487405	NY	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin