Provider Demographics
NPI:1508355371
Name:QUIGLEY, KAYLIN MARIE
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:MARIE
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ROSELLA CT
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6923
Mailing Address - Country:US
Mailing Address - Phone:631-338-4053
Mailing Address - Fax:
Practice Address - Street 1:50 ROSELLA CT
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6923
Practice Address - Country:US
Practice Address - Phone:631-338-4053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty