Macro Medical Diagnostics, PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

208276 Issued in NY

Legal business name

MACRO MEDICAL DIAGNOSTICS, PC

Practice address

464 Main St
Suite B
Port Jefferson, NY 11777-2814

Phone

(631) 331-4268

Fax

(631) 331-4459

NPI assigned

Jul 23, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Scott McWilliams, MD

Title

Director

Phone

(631) 331-4268

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1437389582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117770547",
            "telephone_number": "631-331-4268",
            "fax_number": "631-331-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 MAIN ST",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772814",
            "telephone_number": "631-331-4268",
            "fax_number": "631-331-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACRO MEDICAL DIAGNOSTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "MCWILLIAMS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-331-4268",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "208276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Verdie Lyons, PA-C
• Phillip Ma, DO
• Beverly Wakefield Macauley, R.N.
• Phyllis Macchio, NP
• Kaitlin Macdowell
• Marta Maczaj, M.D.
• Veronica Maguffin
• Asma Mahmood
• Jacqueline A Major, LCSW
• Lisa Malcomson, PT, DPT

• Neurology Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.