Healthcare Provider Details

I. General information

NPI: 1588687313
Provider Name (Legal Business Name): DEBORAH A MC DERMOTT MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E. 68TH STREET, STARR 4 CARDIOLOGY DIVISION
NEW YORK NY
10021
US

IV. Provider business mailing address

170 W 73RD ST APT 8B1
NEW YORK NY
10023-3006
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2054
  • Fax: 212-746-2222
Mailing address:
  • Phone: 212-721-4554
  • Fax: 212-746-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number99204
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: