Individual
MICHELLE ANNE MCKILLOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
887 OLD COUNTRY RD STE GKL, RIVERHEAD, NY 11901-2115
(631) 727-2858
Mailing address
3 SHERWOOD CRES, DIX HILLS, NY 11746-6458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV009141
NY
Other
Enumeration date
06/22/2020
Last updated
06/22/2020
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