Provider Demographics
NPI:1417989864
Name:MCGRATH, ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 W HOMESTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1904
Mailing Address - Country:US
Mailing Address - Phone:856-854-4900
Mailing Address - Fax:856-854-9192
Practice Address - Street 1:3 W HOMESTEAD AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1904
Practice Address - Country:US
Practice Address - Phone:856-854-4900
Practice Address - Fax:856-854-9192
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00586000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2393710000OtherAMERIHEALTH GROUP NUMBER
PA2393710000OtherIBC GROUP NUMBER
PA2393710000OtherKEYSTONE HPE GROUP NUMBER
NJMC052019Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION
PA2393710000OtherIBC GROUP NUMBER