Basic Information
Provider Information
NPI: 1033162235
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCKAY
FirstName: NATASHA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9137
Address2:  
City: BROOKLINE
State: MA
PostalCode: 024469137
CountryCode: US
TelephoneNumber: 6038939784
FaxNumber:  
Practice Location
Address1: 300 CAREW ST
Address2: SUITE 1
City: SPRINGFIELD
State: MA
PostalCode: 011042485
CountryCode: US
TelephoneNumber: 4137812211
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 02/23/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X226295MAY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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