Provider Demographics
NPI:1285443689
Name:CHARM CITY HEALTHCARE, L.L.C.
Entity type:Organization
Organization Name:CHARM CITY HEALTHCARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KHETERPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-527-2760
Mailing Address - Street 1:223 EASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-6936
Mailing Address - Country:US
Mailing Address - Phone:410-687-8818
Mailing Address - Fax:
Practice Address - Street 1:2 MARKET PL
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-4351
Practice Address - Country:US
Practice Address - Phone:410-284-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHARM CITY HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care