Provider Demographics
NPI:1720522147
Name:MCAVOY, KATHERINE (MS SPECIAL ED)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MCAVOY
Suffix:
Gender:F
Credentials:MS SPECIAL ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 208TH ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2719
Mailing Address - Country:US
Mailing Address - Phone:516-567-9937
Mailing Address - Fax:
Practice Address - Street 1:229 LAUREL RD
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-1100
Practice Address - Country:US
Practice Address - Phone:631-659-3337
Practice Address - Fax:631-659-3338
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist