Basic Information
| Provider Information | |||||||||
| NPI: | 1295969491 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCGILL | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | KATHERINE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 SUMMIT ST | ||||||||
| Address2: | CARBHC | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946093412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5106554000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 481 EDWARD H ROSS DR | ||||||||
| Address2: | |||||||||
| City: | ELMWOOD PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074073118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887291206 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2009 | ||||||||
| LastUpdateDate: | 01/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.