Individual
KATHLEEN FITZSIMONS MCCARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
45 W SUFFOLK AVE, SUITE 200, CENTRAL ISLIP, NY 11722-2143
(631) 582-2228
Mailing address
1077 W JERICHO TPKE, SMITHTOWN, NY 11787-3204
(631) 864-7337
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F 381007
NY
Other
Enumeration date
03/14/2008
Last updated
09/11/2013
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