Provider Demographics
NPI:1063575975
Name:MCLAUGHLIN, KATHLEEN LYNCH (DC)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:LYNCH
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PRIDES CROSSING
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6235
Mailing Address - Country:US
Mailing Address - Phone:845-639-9040
Mailing Address - Fax:845-639-9040
Practice Address - Street 1:8301 RIDGE BLVD
Practice Address - Street 2:SUITE L4
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4343
Practice Address - Country:US
Practice Address - Phone:718-748-8044
Practice Address - Fax:718-921-3629
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3363111N00000X
NJ2458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0061732OtherGHI PROVIDER
T52438Medicare UPIN
NYX19141Medicare ID - Type Unspecified