Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | X007469 | NY |
NPI | 1497794747 |
---|---|
Provider Name | Steven Michael Mcmahon |
First Address | New York, NY 10011-3116 |
Second Address | New York, NY 10011-3116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U51507 | (02) | NY |