Individual
COFFEY MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
315 N CENTRAL AVE, APT. 8A, VALLEY STREAM, NY 11580-2502
(347) 743-4003
Mailing address
315 N CENTRAL AVE, APT. 8A, VALLEY STREAM, NY 11580-2502
(347) 743-4003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
486659111
NY
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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