Individual
LALAINE T QUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 MONTAUK HWY, SHIRLEY, NY 11967
(631) 852-1001
(631) 852-1122
Mailing address
29 RIVERVIEW TERRACE, SMITHTOWN, NY 11787
(631) 360-8131
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
211356
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01891478
—
NY
01
—
80176452
RR
—
Enumeration date
08/23/2006
Last updated
07/08/2007
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