Healthcare Provider Details
I. General information
NPI: 1659560357
Provider Name (Legal Business Name): JOANNE V MCLAUGHLIN NP FAMILY HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2007
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
54178 STATE HIGHWAY 30
ROXBURY NY
12474-1543
US
IV. Provider business mailing address
PO BOX 340
NEW HARTFORD NY
13413-0340
US
V. Phone/Fax
- Phone: 607-326-7791
- Fax: 607-326-7794
- Phone: 315-732-9368
- Fax: 315-732-9403
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | F332442 |
| License Number State | NY |
VIII. Authorized Official
Name:
JOANNE
V
MCLAUGHLIN
Title or Position: OWNER/NURSE PRACTIONER
Credential: NP
Phone: 607-326-7791