Individual
COLLEEN CARMODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
148 SAINT MARKS PL, MASSAPEQUA, NY 11758-6422
(516) 376-7082
Mailing address
148 SAINT MARKS PL, MASSAPEQUA, NY 11758-6422
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
350394
NY
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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