Provider Demographics
NPI:1669512133
Name:MCLAUGHLIN, WENDY J (NPP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:J
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BANK ST
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-2410
Mailing Address - Country:US
Mailing Address - Phone:631-369-1277
Mailing Address - Fax:
Practice Address - Street 1:550 E MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2672
Practice Address - Country:US
Practice Address - Phone:631-369-1277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400962-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health