Provider Demographics
NPI:1952412553
Name:MCGRATH, MICHAEL G (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:81 LAKE AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14608-1410
Mailing Address - Country:US
Mailing Address - Phone:585-368-6900
Mailing Address - Fax:585-423-9523
Practice Address - Street 1:81 LAKE AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-1410
Practice Address - Country:US
Practice Address - Phone:585-368-6900
Practice Address - Fax:585-423-9523
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1600962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01286391Medicaid
NYC71008Medicare ID - Type Unspecified70008A GROUP
NYRA6804Medicare ID - Type UnspecifiedBA0017 GROUP
NY5352361OtherAETNA
NY101081EUOtherPREFERRED CARE