Provider Demographics
NPI:1669445748
Name:MCLAUGHLIN, ANNE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 RTE 25A
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-246-6072
Mailing Address - Fax:631-246-6074
Practice Address - Street 1:60 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2872
Practice Address - Country:US
Practice Address - Phone:631-246-6072
Practice Address - Fax:631-246-6074
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0151981225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ45201Medicare UPIN
NYQ4520QC201Medicare PIN