Provider Demographics
NPI:1861521320
Name:MACGILVRAY, ELIZABETH MARY (NP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARY
Last Name:MACGILVRAY
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:34 YORKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1213
Mailing Address - Country:US
Mailing Address - Phone:631-751-2652
Mailing Address - Fax:
Practice Address - Street 1:725 VETERAN'S MEMORIAL HIGHWAY
Practice Address - Street 2:NORTH COUNTY CLINIC BUILDING 151
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-853-6410
Practice Address - Fax:631-853-6413
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF301332-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health