Provider Demographics
NPI:1508120130
Name:MCQUEENY, MADELON MARIE (MS ED, TVI)
Entity Type:Individual
Prefix:MRS
First Name:MADELON
Middle Name:MARIE
Last Name:MCQUEENY
Suffix:
Gender:F
Credentials:MS ED, TVI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4157
Mailing Address - Country:US
Mailing Address - Phone:516-678-0707
Mailing Address - Fax:515-678-5990
Practice Address - Street 1:100 N PARK AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4157
Practice Address - Country:US
Practice Address - Phone:516-678-0707
Practice Address - Fax:516-678-5990
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0528174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0528OtherNEW YORK STATE TEACHER OF BLIND AND PARTIALLY SIGHTED CERTIFICATION