Individual
JUSTIN JOSEPH MCEVOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN PMHNP-BC
Contact information
Practice address
928 HAWKINS AVE, LAKE GROVE, NY 11755-1642
(631) 905-6774
Mailing address
928 HAWKINS AVE, LAKE GROVE, NY 11755-1642
(631) 905-6774
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
406085
NY
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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