Individual
LAUREN LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-2975
Mailing address
121 SPIRAL RD, HOLTSVILLE, NY 11742-2236
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
604402-1
NY
Other
Enumeration date
09/10/2017
Last updated
09/10/2017
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