MEDICARE: MARY ANN MCGRATH LCSW

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
1	1041C0700X	Clinical Social Worker	R041687	NY

General Provider Information

NPI Number	:	1477542900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN MCGRATH LCSW

Provider Business Mailing Address
First Line	:	187 EAST DR
Second Line	:
City	:	NORTH MASSAPEQUA
State	:	NY
Zip	:	11758-1609
Country	:	US
Telephone Number	:	516-735-6700
Fax Number	:	855-262-1981

Provider Business Practice Location Address
First Line	:	187 EAST DR
Second Line	:
City	:	N MASSAPEQUA
State	:	NY
Zip	:	11758-1609
Country	:	US
Telephone Number	:	516-735-6700
Fax Number	:	855-262-1981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	08/30/2021

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