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Individual

MS. PATRICIA M MCLOUGHLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NPP

Contact information

Practice address
102 RACE TRACK RD, SUITE 1, TICONDEROGA, NY 12883-4004
(518) 585-6708
Mailing address
742 NEW VERMONT RD, BOLTON LANDING, NY 12814-4015
(570) 877-8700

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401199
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00630039
NY
Enumeration date
05/12/2009
Last updated
07/19/2011
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