Christine McQuillen, PA

Individual provider Active NPI Medical Physician Assistant · Lloyd Harbor, NY

NPI 1730430752 · NPPES record last updated Oct 1, 2012

Key facts

NPI
1730430752
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
007387 (NY)
Practice address
31 Oakwood Dr
Lloyd Harbor, NY 11743-9748
Phone
(631) 807-1901
Fax
(631) 470-1336
NPI assigned
Oct 1, 2012
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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007387NYMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007387 NY Yes

Addresses

Primary practice location

31 Oakwood Dr
Lloyd Harbor, NY 11743-9748

Mailing address

31 Oakwood Dr
Lloyd Harbor, NY 11743-9748
Phone (631) 807-1901

Other providers in Lloyd Harbor, NY

All providers in Lloyd Harbor, NY · Medical Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.