Provider Demographics
NPI:1902552730
Name:MCMAHON, PATRICK H (NEW YORK STATE REGIS)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:H
Last Name:MCMAHON
Suffix:
Gender:M
Credentials:NEW YORK STATE REGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3452 STATE ROUTE 31 SUITE 2
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027
Mailing Address - Country:US
Mailing Address - Phone:315-944-3012
Mailing Address - Fax:315-944-3002
Practice Address - Street 1:3452 STATE ROUTE 31 SUITE 2
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027
Practice Address - Country:US
Practice Address - Phone:315-944-3012
Practice Address - Fax:315-944-3002
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000067506237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist