Provider Demographics
NPI:1497794747
Name:MCMAHON, STEVEN MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:MCMAHON
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 1:231 W 21ST ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3116
Mailing Address - Country:US
Mailing Address - Phone:212-243-6384
Mailing Address - Fax:212-243-6142
Practice Address - Street 1:231 W 21ST ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3116
Practice Address - Country:US
Practice Address - Phone:212-243-6384
Practice Address - Fax:212-243-6142
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007469111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU51507Medicare UPIN
NYX59792Medicare ID - Type Unspecified