Individual
MARY SHANNON MCGINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 693-5860
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 693-5860
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22-604904 08
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
30-307128 10
NY
Other
Enumeration date
02/16/2015
Last updated
02/16/2015
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