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NPI Code Detail

MEDICARE: MRS. CAROL LYNN CHIRCO

MEDICARE:  MRS. CAROL LYNN CHIRCO
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
1103K00000XBehavior Analyst1739346NY

General Provider Information

NPI Number : 1528404019
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROL LYNN CHIRCO
Provider Business Mailing Address
First Line : 103 RIVER HEIGHTS DR
Second Line :
City : SMITHTOWN
State : NY
Zip : 11787-1754
Country : US
Telephone Number : 631-724-1708
Fax Number :
Provider Business Practice Location Address
First Line : 103 RIVER HEIGHTS DR
Second Line :
City : SMITHTOWN
State : NY
Zip : 11787-1754
Country : US
Telephone Number : 631-724-1708
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2013
Last Update Date : 05/11/2013

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Directions to “ MRS. CAROL LYNN CHIRCO ” Practice Location

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