Provider Demographics
NPI:1386990695
Name:MINOGUE, MARGARET MARY (MAED)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MARY
Last Name:MINOGUE
Suffix:
Gender:F
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 YUMA LN
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-2639
Mailing Address - Country:US
Mailing Address - Phone:631-834-1904
Mailing Address - Fax:
Practice Address - Street 1:47 YUMA LN
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-2639
Practice Address - Country:US
Practice Address - Phone:631-834-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist