Individual
LUCILLE TERESE VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FPS
Contact information
Practice address
208 ROANOKE AVE, RIVERHEAD, NY 11901-2706
(631) 772-3287
(631) 284-2541
Mailing address
208 ROANOKE AVE, RIVERHEAD, NY 11901-2706
(631) 772-3287
(631) 284-2541
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
NY
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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