Basic Information
| Provider Information | |||||||||
| NPI: | 1780271668 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCADAM | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | BURNELL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVENUS BOX 671 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146420001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852752986 | ||||||||
| FaxNumber: | 5852753366 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 E RIVER RD | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146231212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852752986 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2020 | ||||||||
| LastUpdateDate: | 12/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 000336 | NY | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.