Provider Demographics
NPI:1356369060
Name:MCMAHON, GERALD V (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:V
Last Name:MCMAHON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:104 UNION AVE. SUITE 806
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203
Mailing Address - Country:US
Mailing Address - Phone:315-703-5180
Mailing Address - Fax:315-703-2567
Practice Address - Street 1:182 INTREPID LN
Practice Address - Street 2:BRIGHTON MEDICAL ASSOCIATES
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13205
Practice Address - Country:US
Practice Address - Phone:315-218-7020
Practice Address - Fax:315-218-7050
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2017-05-10
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Provider Licenses
StateLicense IDTaxonomies
NY177937207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01209645Medicaid
NY01209645Medicaid