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Individual

MRS. CARRIE R MCDERMOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 PAM CT, SOUTH SETAUKET, NY 11720-1158
(631) 275-6570
Mailing address
1 PAM CT, SOUTH SETAUKET, NY 11720-1158
(631) 275-6570

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
1119438
NY
174400000X
Specialist
363152911
NY
174400000X
Specialist
514265111
NY
174400000X
Specialist
516370112
NY
174400000X
Specialist
Primary
516371112
NY
174400000X
Specialist
563369112
NY
174400000X
Specialist
563372112
NY

Other

Enumeration date
06/05/2012
Last updated
06/05/2012
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