Provider Demographics
NPI:1396978334
Name:MCENERNEY, MARY H (NP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:H
Last Name:MCENERNEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W 27TH ST
Mailing Address - Street 2:A402
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5902
Mailing Address - Country:US
Mailing Address - Phone:212-217-4190
Mailing Address - Fax:212-217-4191
Practice Address - Street 1:227 W 27TH ST
Practice Address - Street 2:A402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5902
Practice Address - Country:US
Practice Address - Phone:212-217-4190
Practice Address - Fax:212-217-4191
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY331808363LF0000X
FL9256273363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily