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NPI Code Detail

MEDICARE: BERNADETTE MARIE MCMAHON

MEDICARE: BERNADETTE MARIE MCMAHON
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
1225XP0200XPediatric Occupational Therapist63021155NY

General Provider Information

NPI Number : 1285179739
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERNADETTE MARIE MCMAHON
Provider Business Mailing Address
First Line : 611 MINNIEFORD AVE
Second Line :
City : BRONX
State : NY
Zip : 10464-1121
Country : US
Telephone Number : 718-885-1197
Fax Number :
Provider Business Practice Location Address
First Line : 611 MINNIEFORD AVE
Second Line :
City : BRONX
State : NY
Zip : 10464-1121
Country : US
Telephone Number : 718-885-1197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2016
Last Update Date : 12/19/2016

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Directions to “ BERNADETTE MARIE MCMAHON ” Practice Location

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