Provider Demographics
NPI:1558631861
Name:MERRIGAN, KATHY MARY (MSED)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:MARY
Last Name:MERRIGAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2376 WILLOUGHBY AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2956
Mailing Address - Country:US
Mailing Address - Phone:516-804-5900
Mailing Address - Fax:516-804-5900
Practice Address - Street 1:2376 WILLOUGHBY AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2956
Practice Address - Country:US
Practice Address - Phone:516-804-5900
Practice Address - Fax:516-804-5900
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst