Provider Demographics
NPI:1316098270
Name:MCMAHON, JUDITH A (AUD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:A
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-2709
Mailing Address - Country:US
Mailing Address - Phone:607-756-8915
Mailing Address - Fax:607-756-1820
Practice Address - Street 1:9 CHURCH ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-2709
Practice Address - Country:US
Practice Address - Phone:607-756-8915
Practice Address - Fax:607-756-1820
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001450-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS44397Medicare UPIN
NYRA4091Medicare ID - Type Unspecified