Individual
MARA PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1824 MADISON AVE FL 5, NEW YORK, NY 10035-3832
(212) 423-4500
Mailing address
1824 MADISON AVE FL 5, NEW YORK, NY 10035-3832
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
312028
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2019
Last updated
09/07/2022
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