Provider Demographics
NPI:1962776229
Name:MCGRATH, JANICE MARIE (LPN)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:MARIE
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1247
Mailing Address - Street 2:
Mailing Address - City:PORT EWEN
Mailing Address - State:NY
Mailing Address - Zip Code:12466-1247
Mailing Address - Country:US
Mailing Address - Phone:845-520-8448
Mailing Address - Fax:
Practice Address - Street 1:192 W STOUT AVE
Practice Address - Street 2:
Practice Address - City:PORT EWEN
Practice Address - State:NY
Practice Address - Zip Code:12466-7745
Practice Address - Country:US
Practice Address - Phone:845-520-8448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254826164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse