Healthcare Provider Details

I. General information

NPI: 1255443834
Provider Name (Legal Business Name): JOANNE V MCLAUGHLIN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/09/2008
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

Practice location:
  • Phone: 607-326-7791
  • Fax: 607-326-7794
Mailing address:
  • Phone: 315-732-9368
  • Fax: 315-732-9403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF332442-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: