Individual
DR. CHRISTIAN PAUL MCDONOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
351 MAYWOOD AVE FL 2, MAYWOOD, NJ 07607-1906
(201) 546-1374
Mailing address
351 MAYWOOD AVE FL 2, MAYWOOD, NJ 07607-1906
(201) 546-1374
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA08741600
NJ
275N00000X
Medicare Defined Swing Bed Hospital Unit
240836
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236934
—
NJ
01
—
P00953296
RR MCR PTAN
NJ
Enumeration date
07/23/2007
Last updated
09/21/2011
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