Individual provider · Type 1 NPI

Mary McKillop

Specialist · Ravena, NY

NPI number 1891243218 Active

Practice location

14379 Rt 9W, Circle Of Friends
Ravena, NY 12143-3103

Call (518) 756-3124 Map

Fax (518) 756-9476

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X304575 (NY)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1891243218

Mary McKillop's National Provider Identifier is 1891243218, issued on Sep 14, 2016. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Ravena, NY. The record was last updated on Sep 14, 2016.