Provider Demographics
NPI:1649390360
Name:MCGUIRE, CAROL ANN (AUD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-1420
Mailing Address - Country:US
Mailing Address - Phone:631-732-8030
Mailing Address - Fax:
Practice Address - Street 1:35 MIDDLE COUNTRY RD
Practice Address - Street 2:STE. M
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-4435
Practice Address - Country:US
Practice Address - Phone:631-732-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000276-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist