Individual
MRS. IRENE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
516 MONTAUK HWY, EAST MORICHES, NY 11940-1225
(631) 874-2900
(631) 874-2948
Mailing address
516 MONTAUK HWY, EAST MORICHES, NY 11940-1225
(631) 874-2900
(631) 874-2948
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F301015
NY
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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