Provider Demographics
NPI:1710614847
Name:MCTIGHE, MARY F (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:MCTIGHE
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 S KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5617
Mailing Address - Country:US
Mailing Address - Phone:516-732-1812
Mailing Address - Fax:
Practice Address - Street 1:70 E SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1240
Practice Address - Country:US
Practice Address - Phone:516-732-1812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist