Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 25MA07260400 | NJ |
NPI | 1275640518 |
---|---|
Provider Name | Dr. Claire Kathleen Mcmahon |
First Address | Glen Ridge, NJ 07028-2408 |
Second Address | Newark, NJ 07103-2425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 31/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8633801 | (05) | NJ |
H48988 | (02) | NJ |