Healthcare Provider Details

I. General information

NPI: 1578924064
Provider Name (Legal Business Name): EDITH MARIE SETON MCCAFFREY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 LITTLE PLAINS RD
HUNTINGTON NY
11743-4550
US

IV. Provider business mailing address

25 LITTLE PLAINS ROAD
HUNTINGTON NY
11743
US

V. Phone/Fax

Practice location:
  • Phone: 631-266-4409
  • Fax: 631-923-1955
Mailing address:
  • Phone: 631-266-4409
  • Fax: 631-923-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number6903891
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: