Provider Demographics
NPI:1316974470
Name:MCGOWAN, ANNE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2130
Mailing Address - Country:US
Mailing Address - Phone:908-654-6366
Mailing Address - Fax:908-654-6319
Practice Address - Street 1:138 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2130
Practice Address - Country:US
Practice Address - Phone:908-654-6366
Practice Address - Fax:908-654-6319
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00113700363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP1082680OtherOXFORD
NJ1121207OtherAETNA HMO
NJ0104669000OtherAMERIHEALTH HMO
NJ1565030OtherAMERIHEALTH PPO
NJ1704605Medicaid
NJ8219546OtherGHI
NJ4109260OtherAETNA
NJ1704605Medicaid
NJ4109260OtherAETNA
NJP1082680OtherOXFORD