Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 180749 | NY |
NPI | 1427034354 |
---|---|
Provider Name | Mary A Mcgrath |
First Address | Syracuse, NY 13202-3056 |
Second Address | Syracuse, NY 13210-2306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 17/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01245674 | (05) | NY |