Provider Demographics
NPI:1053146654
Name:MCMASTER, AUDREY B
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:B
Last Name:MCMASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 MAUJER ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-1075
Mailing Address - Country:US
Mailing Address - Phone:301-467-4588
Mailing Address - Fax:
Practice Address - Street 1:99 WALL ST STE 1665
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-4301
Practice Address - Country:US
Practice Address - Phone:347-991-9246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health