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Individual

BRIAN R COYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
83 E MAIN ST, BAY SHORE, NY 11706-8305
(631) 666-1951
Mailing address
31 WILLOW AVE, ISLIP, NY 11751-3915
(631) 859-3436

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101523-1
NY

Other

Enumeration date
08/27/2018
Last updated
08/27/2018
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