Provider Demographics
NPI:1609137405
Name:REID, JUNE MAIRE (MSPED PERM CERT)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:MAIRE
Last Name:REID
Suffix:
Gender:F
Credentials:MSPED PERM CERT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 BURNEY BLVD
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-1338
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:84 BURNEY BLVD
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950-1338
Practice Address - Country:US
Practice Address - Phone:631-772-2477
Practice Address - Fax:631-772-2477
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist