Provider Demographics
NPI:1740278472
Name:MCMAHON, JAMES T (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:T
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:67 SAND PIT RD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4032
Mailing Address - Country:US
Mailing Address - Phone:203-743-7246
Mailing Address - Fax:203-792-3920
Practice Address - Street 1:67 SAND PIT RD
Practice Address - Street 2:SUITE 308
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4032
Practice Address - Country:US
Practice Address - Phone:203-743-7246
Practice Address - Fax:203-792-3920
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2011-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT001333363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT970001381Medicare ID - Type Unspecified
P95679Medicare UPIN