Individual
CARRIE ANN ANN MCGUIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 CALIFORNIA AVE, PORT JEFFERSON, NY 11777-1501
(631) 512-8390
Mailing address
111 CALIFORNIA AVE, PORT JEFFERSON, NY 11777-1501
(631) 512-8390
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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