Healthcare Provider Details

I. General information

NPI: 1568463867
Provider Name (Legal Business Name): MARYANN MCLAUGHLIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 98TH ST FL 3
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

ONE GUSTAVE LEVY PLACE 1030
NEW YORK NY
10029
US

V. Phone/Fax

Practice location:
  • Phone: 212-427-1540
  • Fax: 212-410-7196
Mailing address:
  • Phone: 212-731-7830
  • Fax: 212-369-3269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number1923021
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: