Provider Demographics
NPI:1386452308
Name:MCMAUGH, LIANA
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:MCMAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 N SHULER RD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:NY
Mailing Address - Zip Code:14805-9603
Mailing Address - Country:US
Mailing Address - Phone:631-871-0082
Mailing Address - Fax:
Practice Address - Street 1:3220 N SHULER RD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:NY
Practice Address - Zip Code:14805-9603
Practice Address - Country:US
Practice Address - Phone:631-871-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY904338163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse