Individual
MISS CORINNE M. WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
252 ISLIP AVE, ISLIP, NY 11751-3029
(631) 581-6800
(631) 581-6814
Mailing address
101 SYLVAN AVE APT 25, MILLER PLACE, NY 11764-2400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7683
NY
Other
Enumeration date
03/02/2009
Last updated
03/02/2009
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