Provider Demographics
NPI:1760775787
Name:MCLAUGHLIN, JONATHAN ANDREW (PA-C, RT-R)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:ANDREW
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:PA-C, RT-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 1ST AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7954
Mailing Address - Country:US
Mailing Address - Phone:646-387-1517
Mailing Address - Fax:
Practice Address - Street 1:14 1ST AVE APT 3D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7954
Practice Address - Country:US
Practice Address - Phone:646-387-1517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014741-01363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant