Provider Demographics
NPI:1770825614
Name:MCGRATH, ANIKA L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIKA
Middle Name:L
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANIKA
Other - Middle Name:L
Other - Last Name:MIRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:425 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8722
Mailing Address - Country:US
Mailing Address - Phone:646-962-9650
Mailing Address - Fax:212-821-0671
Practice Address - Street 1:425 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8722
Practice Address - Country:US
Practice Address - Phone:646-962-9650
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD605770132085R0202X
NY304517-012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2036634Medicaid
WA1770825614Medicaid