Provider Demographics
NPI:1487633442
Name:MCBANE, DEBORAH (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:MCBANE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4816
Mailing Address - Country:US
Mailing Address - Phone:516-267-6854
Mailing Address - Fax:516-745-5476
Practice Address - Street 1:975 STEWART AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4816
Practice Address - Country:US
Practice Address - Phone:516-267-6854
Practice Address - Fax:516-745-5476
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYS203802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5614611OtherAETNA
110185724OtherRAILROAD MEDICARE
NY2589118OtherGHI
NY5C4747OtherHEALTHNET
1307773OtherFIRST HEALTH
NY01809609Medicaid
80758OtherVYTRA
NY0480464OtherCIGNA
NY385AB1OtherBCBS
NYP3671639OtherOXFORD
1786142OtherUNITED HEALTHCARE
5614611OtherAETNA
1786142OtherUNITED HEALTHCARE