Individual
JACK ALBERT MCENROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
173 WINDWATCH DR, HAUPPAUGE, NY 11788-3353
(516) 672-5771
Mailing address
70 N WOODHULL RD APT 1, HUNTINGTON, NY 11743-2858
(516) 330-9753
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
12/07/2025
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