Provider Demographics
NPI:1013017532
Name:MCKAY, CECILE (MD)
Entity Type:Individual
Prefix:
First Name:CECILE
Middle Name:
Last Name:MCKAY
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 1:100 SULLIVAN WAY
Mailing Address - Street 2:
Mailing Address - City:WEST TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08862-0500
Mailing Address - Country:US
Mailing Address - Phone:609-633-1502
Mailing Address - Fax:
Practice Address - Street 1:200 SULLIVAN WAY
Practice Address - Street 2:
Practice Address - City:WEST TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08625-2306
Practice Address - Country:US
Practice Address - Phone:609-633-1502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05223000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ716759C2DOtherMEDICARE BILLING NO.
NJ716759C2DOtherMEDICARE BILLING NO.