Individual
MR. BRIAN CHRISTOPHER MAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
65 HAWTHORNE AVE, WEST BABYLON, NY 11704-7307
(631) 617-2470
Mailing address
65 HAWTHORNE AVE, WEST BABYLON, NY 11704-7307
(631) 617-2470
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1082505
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1082505
SPECIAL EDUCATOR
NY
Enumeration date
06/14/2012
Last updated
06/14/2012
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