location
search-icon
person
Tracey Marie Southard
Specialist in Medford, New York
NPI 1215298260

Tracey Marie Southard is a Specialist based in East Patchogue, NY. Tracey Marie Southard practices in Medford, NY. The NPI Number for Tracey Marie Southard is 1215298260 and holds a License No. 764610 (New York).

The current practice location address for Tracey Marie Southard is 1 Scouting Blvd, Medford, NY and can be reached out via phone at 631-745-0317.

Location: 1 Scouting Blvd, Medford, NY, 11772-4560
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215298260
Provider Name
Tracey Marie Southard
Credential
Provider Entity Type
Individual
Gender
Female
Address
1 Scouting Blvd, Medford, NY, 11772-4560
Phone Number
631-745-0317
Fax Number
Provider Enumeration Date
06/06/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1 Scouting Blvd
City
Medford
State
New York
Zip
11763-2220
Phone Number
631-745-0317
Fax Number
person
Provider Business Mailing Address Details
Address
1 Scouting Blvd
City
Medford
State
New York
Zip
11763-2220
Phone Number
631-745-0317
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
764610 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.