Individual
MRS. BRYNN KATHERINE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
38 FURWOOD DRIVE, EAST NORTHPORT, NY 11731
(917) 572-6857
Mailing address
38 FURWOOD DR, EAST NORTHPORT, NY 11731-3116
(917) 572-6857
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2578006
NY
Other
Enumeration date
09/12/2017
Last updated
07/21/2022
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