Individual
MARIE D ROY LICIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9406 JAMAICA AVE, WOODHAVEN, NY 11421-2221
(631) 366-3876
Mailing address
15 EDDIE AVE, NORTH BABYLON, NY 11703-2712
(631) 949-8392
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
020736
NY
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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