Provider Demographics
NPI:1053566786
Name:MCDONAGH, MARY VALENTINE (N P)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:VALENTINE
Last Name:MCDONAGH
Suffix:
Gender:F
Credentials:N P
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:170 W 12TH ST
Mailing Address - Street 2:SPELLMAN 691
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:212-604-8670
Mailing Address - Fax:212-604-7828
Practice Address - Street 1:170 W 12TH ST
Practice Address - Street 2:SPELLMAN 691
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-8670
Practice Address - Fax:212-604-7828
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF331738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily