Healthcare Provider Details

I. General information

NPI: 1356700017
Provider Name (Legal Business Name): KATHLEEN MARY BARNOSKY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN MARY MCMONIGLE R.N.

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 WOLF HILL ROAD
SOUTH HUNTINGTON NY
11747
US

IV. Provider business mailing address

60 WESTON STREET
HUNTINGTON STATION NY
11746
US

V. Phone/Fax

Practice location:
  • Phone: 631-271-2020
  • Fax: 631-547-6820
Mailing address:
  • Phone: 631-812-3000
  • Fax: 631-812-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number282485-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: