Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 200117 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 200117 | NY |
NPI | 1336226679 |
---|---|
Provider Name | Dr. Thomas James Mcnanley |
First Address | Minneapolis, MN 55425-4516 |
Second Address | St Louis Park, MN 55426-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 29/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01585708 | (05) | NY |
E90255 | (02) | NY |