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Individual

MR. FRANK JOSEPH DAUGHERTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
216 1ST ST, MINEOLA, NY 11501-3901
(516) 663-2216
Mailing address
30 LITTLE NECK RD, CENTERPORT, NY 11721-1668
(631) 239-1323
(631) 239-1323

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
407130
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11-3465690
TAX ID
NY
01
407130
LICENSE
NY
Enumeration date
06/30/2006
Last updated
08/11/2022
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