Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 172678 | NY |
Y | 208000000X | Pediatrician | 172678 | NY |
NPI | 1821046947 |
---|---|
Provider Name | Dr. Margaret Mary Mcgovern |
First Address | Halesite, NY 11743-1339 |
Second Address | Stony Brook, NY 11794-8111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 02/08/2007 |