Provider Demographics
NPI:1396904348
Name:D JAMES MCKAY PC
Entity type:Organization
Organization Name:D JAMES MCKAY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-482-8556
Mailing Address - Street 1:990 MIGEON AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4555
Mailing Address - Country:US
Mailing Address - Phone:860-482-8556
Mailing Address - Fax:860-626-0361
Practice Address - Street 1:990 MIGEON AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-4555
Practice Address - Country:US
Practice Address - Phone:860-482-8556
Practice Address - Fax:860-626-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD76996Medicare UPIN
CT010000644Medicare PIN