Provider Demographics
NPI:1548219249
Name:MCBAIN, ANDREW ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ALEXANDER
Last Name:MCBAIN
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 1:7440 GOSHEN CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-5558
Mailing Address - Country:US
Mailing Address - Phone:201-941-8550
Mailing Address - Fax:
Practice Address - Street 1:THE BASIC SCHOOL RAY HEALTH CLINIC
Practice Address - Street 2:MCB2 24008
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22134
Practice Address - Country:US
Practice Address - Phone:703-432-6396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00234300111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ112355Medicare PIN
NJUO8686Medicare UPIN
NJ112355QCBMedicare PIN
NJ112355S30Medicare PIN
NYA400045118Medicare PIN