Provider Demographics
NPI:1609027226
Name:HAUGHN, CLARE MARIE
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:MARIE
Last Name:HAUGHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:MARIE
Other - Last Name:RINGHOFF-HAUGHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:71 PAQUATUCK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-1205
Mailing Address - Country:US
Mailing Address - Phone:631-878-1778
Mailing Address - Fax:631-878-1778
Practice Address - Street 1:71 PAQUATUCK AVE
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940-1205
Practice Address - Country:US
Practice Address - Phone:631-878-1778
Practice Address - Fax:631-878-1778
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008151-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker