Healthcare Provider Details

I. General information

NPI: 1457264236
Provider Name (Legal Business Name): NOEL HAZARD MCGRORY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 FORT WASHINGTON AVE
NEW YORK NY
10032-3733
US

IV. Provider business mailing address

60 HAVEN AVE
NEW YORK NY
10032-2604
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-2862
  • Fax:
Mailing address:
  • Phone: 914-643-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: