Provider Demographics
NPI:1598008674
Name:MCKINSTRY, JAMES PATRICK (MS, PD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:MCKINSTRY
Suffix:
Gender:M
Credentials:MS, PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 DRAKE AVE APT 4F
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805
Mailing Address - Country:US
Mailing Address - Phone:631-804-8742
Mailing Address - Fax:
Practice Address - Street 1:197 DRAKE AVE APT 4F
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-1782
Practice Address - Country:US
Practice Address - Phone:631-804-8742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY538540111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist