Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 4961 | CT |
NPI | 1063026938 |
---|---|
Provider Name | Jacqueline Mcginley |
First Address | Madison, WI 53719-4539 |
Second Address | West Haven, CT 06516-2770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2020 |
Last Update Date | 08/09/2020 |