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NPI Code Detail

MEDICARE: MICKAILA MCLAUGHLIN

MEDICARE:   MICKAILA  MCLAUGHLIN
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
1163WP2201XAmbulatory Care Registered Nurse893111-01NY

General Provider Information

NPI Number : 1699623389
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICKAILA MCLAUGHLIN
Provider Business Mailing Address
First Line : 288 EASTON ST
Second Line :
City : RONKONKOMA
State : NY
Zip : 11779-6102
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 101 SOUTH DRIVE
Second Line :
City : STONY BROOK
State : NY
Zip : 11794-0001
Country : US
Telephone Number : 631-632-8989
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ MICKAILA MCLAUGHLIN ” Practice Location

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