McKenzie Callagy, LPN

Individual provider Active NPI Licensed Practical Nurse · Shirley, NY

NPI 1023665643 · NPPES record last updated Dec 4, 2019

Key facts

NPI
1023665643
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
330852 (NY)
Practice address
105 Moriches Middle Island Rd
Shirley, NY 11967-1229
Phone
(631) 965-7165
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 330852 NY Yes

Addresses

Primary practice location

105 Moriches Middle Island Rd
Shirley, NY 11967-1229

Mailing address

105 Moriches Middle Island Rd
Shirley, NY 11967-1229
Phone (631) 965-7165

Other providers in Shirley, NY

All providers in Shirley, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.