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Individual

EDWARD MCCORMACK MOLLOY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
1661 OLD COUNTRY RD UNIT 428, RIVERHEAD, NY 11901-4420
(631) 375-9727
Mailing address
1661 OLD COUNTRY RD UNIT 428, RIVERHEAD, NY 11901-4420
(631) 375-9727

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
709109
NY

Other

Enumeration date
11/16/2015
Last updated
11/16/2015
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