Individual
CHAMPAGNE MCLARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 WATER ST, WHITE PLAINS, NY 10601-1401
(347) 859-6064
Mailing address
12 WATER ST, WHITE PLAINS, NY 10601-1401
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
353065
NY
Other
Enumeration date
05/01/2025
Last updated
05/01/2025
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