Provider Demographics
NPI:1336245356
Name:FRANCIS, CHARLES JEROME (DO)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:JEROME
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 QUAKERBRIDGE PLZ STE E
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1255
Mailing Address - Country:US
Mailing Address - Phone:609-245-8759
Mailing Address - Fax:609-245-8760
Practice Address - Street 1:8 QUAKERBRIDGE PLZ STE E
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1255
Practice Address - Country:US
Practice Address - Phone:609-245-8759
Practice Address - Fax:609-245-8760
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200268207Q00000X
NJ25MB11689300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0953946Medicaid
NY01632439Medicaid
NYG40113Medicare UPIN
NY02544Medicare ID - Type Unspecified