Basic Information
| Provider Information | |||||||||
| NPI: | 1407462708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGEARY | ||||||||
| FirstName: | KAYLEE | ||||||||
| MiddleName: | SHEA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2851 FALLS RD | ||||||||
| Address2: | |||||||||
| City: | FALLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 186157732 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702901398 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1081 OAK ST STE 3 | ||||||||
| Address2: | |||||||||
| City: | INKERMAN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 186403716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708023099 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2020 | ||||||||
| LastUpdateDate: | 09/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | PA | Y |
No ID Information.