Individual
ALYSE KATHLEEN MIDDENORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 HICKSVILLE RD, MASSAPEQUA, NY 11758-5819
(516) 524-4468
Mailing address
116 WEBSTER ST, MERRICK, NY 11566-2617
(516) 524-4468
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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