Provider Demographics
NPI:1295079267
Name:MCGUIGAN, COLLEEN P (LPN)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:P
Last Name:MCGUIGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CUSA DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2307
Mailing Address - Country:US
Mailing Address - Phone:845-532-7804
Mailing Address - Fax:
Practice Address - Street 1:3 CUSA DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528
Practice Address - Country:US
Practice Address - Phone:845-532-7804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307925372600000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No372600000XNursing Service Related ProvidersAdult Companion