Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 030135 | CT |
NPI | 1205906419 |
---|---|
Provider Name | Joseph Michael Mcnamara |
First Address | Guilford, CT 06437-2003 |
Second Address | Guilford, CT 06437-2003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4396471 | (05) | CT |
E46532 | (02) |