Provider Demographics
NPI:1568463867
Name:MCLAUGHLIN, MARYANN (MD)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE GUSTAVE LEVY PLACE
Mailing Address - Street 2:1030
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-731-7830
Mailing Address - Fax:212-369-3269
Practice Address - Street 1:5 E 98TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-427-1540
Practice Address - Fax:212-410-7196
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1923021207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01614337Medicaid
NY01614337Medicaid
NYG17846Medicare UPIN