Provider Demographics
NPI:1710432034
Name:MOLONEY, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MOLONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 RIDER AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-3956
Mailing Address - Country:US
Mailing Address - Phone:631-241-5696
Mailing Address - Fax:
Practice Address - Street 1:139 RIDER AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-3956
Practice Address - Country:US
Practice Address - Phone:631-241-5696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist