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NPI Code Detail

MEDICARE: DR. KATHLEEN L MCDONALD MD

MEDICARE: DR. KATHLEEN L MCDONALD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085N0904XNuclear Radiology PhysicianMA03538300NJ
22085R0202XDiagnostic Radiology Physician25MA03538300NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346246048
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN L MCDONALD MD
Provider Business Mailing Address
First Line : 579A CRANBURY RD
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-5426
Country : US
Telephone Number : 732-390-0040
Fax Number : 732-955-8874
Provider Business Practice Location Address
First Line : 300 2ND AVE
Second Line :
City : LONG BRANCH
State : NJ
Zip : 07740-6303
Country : US
Telephone Number : 732-390-0040
Fax Number : 732-955-8874
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 10/02/2020

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