Craddock, Michelle Marilyn
Craddock, Michelle Marilyn is an sole proprietor health care provider with primary practice located at 625 Belle Terre Rd Suite 119 Port Jefferson Medical Assoc, Port Jefferson NY 11777. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Craddock, Michelle Marilyn can be contacted via phone (631) 642-0609.Contact Information
Primary practice address
625 Belle Terre Rd Suite 119 Port Jefferson Medical Assoc
Port Jefferson NY 11777
Phone: (631) 642-0609
Fax: (631) 642-0588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | F3325721 | New York |
Profile Details
| NPI number | 1013182112 |
|---|---|
| LBN Legal business name | Craddock, Michelle Marilyn |
| Credentials | Adult Nurse Practitioner (ANP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 29th, 2008 |
| Last updated | Apr 29th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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