Healthcare Provider Details
I. General information
NPI: 1497794747
Provider Name (Legal Business Name): STEVEN MICHAEL MCMAHON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
231 W 21ST ST LOWER LEVEL
NEW YORK NY
10011-3116
US
IV. Provider business mailing address
231 W 21ST ST LOWER LEVEL
NEW YORK NY
10011-3116
US
V. Phone/Fax
- Phone: 212-243-6384
- Fax: 212-243-6142
- Phone: 212-243-6384
- Fax: 212-243-6142
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN0400X |
| Taxonomy | Neurology Chiropractor |
| License Number | X007469 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: