Provider Demographics
NPI:1265863278
Name:MCMAHON, KATHERINE SANDBACH (PA-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SANDBACH
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:19 WEST AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6049
Mailing Address - Country:US
Mailing Address - Phone:518-693-4635
Mailing Address - Fax:518-682-3001
Practice Address - Street 1:19 WEST AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6049
Practice Address - Country:US
Practice Address - Phone:518-693-4635
Practice Address - Fax:518-682-3001
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY017220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant