Individual
CAROL M DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 HASKEL LANE, STONY BROOK, NY 11790
(631) 751-1979
Mailing address
7 HASKEL LN, STONY BROOK, NY 11790-2310
(631) 751-1979
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/18/2017
Last updated
07/21/2022
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