Basic Information
Provider Information | |||||||||
NPI: | 1548274392 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MCGARRY | ||||||||
FirstName: | TERENCE | ||||||||
MiddleName: | M. | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 7901 BROADWAY | ||||||||
Address2: | ROOM A1-9 | ||||||||
City: | ELMHURST | ||||||||
State: | NY | ||||||||
PostalCode: | 113731329 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7183344952 | ||||||||
FaxNumber: | 7183344815 | ||||||||
Practice Location | |||||||||
Address1: | 7901 BROADWAY | ||||||||
Address2: | ROOM A1-9 | ||||||||
City: | ELMHURST | ||||||||
State: | NY | ||||||||
PostalCode: | 113731329 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7183344952 | ||||||||
FaxNumber: | 7183344815 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/28/2006 | ||||||||
LastUpdateDate: | 10/22/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 135070 | NY | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207RP1001X | 135070 | NY | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
ID | Type | State | Issuer | Description | 01010439 | 05 | NY |   | MEDICAID |