Healthcare Provider Details

I. General information

NPI: 1033283668
Provider Name (Legal Business Name): CHRISTINE MARIE MCLAUGHLIN MA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 JERUSALEM AVE SUITE 106
NORTH BELLMORE NY
11710-1870
US

IV. Provider business mailing address

2150 PARKSIDE DRIVE
SEAFORD NY
11783
US

V. Phone/Fax

Practice location:
  • Phone: 516-785-5257
  • Fax:
Mailing address:
  • Phone: 516-785-5616
  • Fax: 516-785-5616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number0125881
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: