Provider Demographics
NPI:1174826960
Name:MCGAHEE, ADAM RAY (PMH-NP)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:RAY
Last Name:MCGAHEE
Suffix:
Gender:M
Credentials:PMH-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 GLEBE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3109
Mailing Address - Country:US
Mailing Address - Phone:901-568-2177
Mailing Address - Fax:
Practice Address - Street 1:2527 GLEBE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3109
Practice Address - Country:US
Practice Address - Phone:901-568-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401356363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health