Individual
CARLY MACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
134 BURKHALL ST APT 105, WEYMOUTH, MA 02190-3571
(914) 500-5212
Mailing address
23 WASHINGTON PL E, WHITE PLAINS, NY 10603-1716
(914) 500-5212
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2330353
MA
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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