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NPI Code Detail

MEDICARE: DOROTHY MCLOUGHLIN FNP

MEDICARE:   DOROTHY  MCLOUGHLIN  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner345700NY

General Provider Information

NPI Number : 1356976740
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY MCLOUGHLIN FNP
Provider Business Mailing Address
First Line : 18 MOODY PL
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-1632
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18 MOODY PL
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10310-1632
Country : US
Telephone Number : 718-873-4812
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2020
Last Update Date : 03/06/2020

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