Individual
OISIN MCELLIGOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4 AVIS CT, BLAUVELT, NY 10913-1006
(845) 653-1603
Mailing address
4 AVIS CT, BLAUVELT, NY 10913-1006
(845) 653-1603
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
64008470
NY
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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