Healthcare Provider Details

I. General information

NPI: 1649166380
Provider Name (Legal Business Name): CAROLYN E MCMAHON NP IN FAMILY HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SPENCER ST STE 1501
BROOKLYN NY
11205-5343
US

IV. Provider business mailing address

2604 ELMWOOD AVE STE 322
ROCHESTER NY
14618-2213
US

V. Phone/Fax

Practice location:
  • Phone: 212-734-6621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN ELIZABETH MCMAHON
Title or Position: OWNER
Credential:
Phone: 212-734-6621