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NPI Code Detail

MEDICARE: KAYLYN MCDONALD

MEDICARE:   KAYLYN  MCDONALD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist611977121NY

General Provider Information

NPI Number : 1154683688
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLYN MCDONALD
Provider Business Mailing Address
First Line : 50 BEACH 217TH ST
Second Line :
City : BREEZY POINT
State : NY
Zip : 11697-1520
Country : US
Telephone Number : 347-558-1975
Fax Number :
Provider Business Practice Location Address
First Line : 50 BEACH 217TH ST
Second Line :
City : BREEZY POINT
State : NY
Zip : 11697-1520
Country : US
Telephone Number : 347-558-1975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 06/11/2012

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Directions to “ KAYLYN MCDONALD ” Practice Location

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