Healthcare Provider Details

I. General information

NPI: 1750548285
Provider Name (Legal Business Name): DAVID JOSEPH MCNAMARA R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CAMPBELL AVE
WEST HAVEN CT
06516-2770
US

IV. Provider business mailing address

950 CAMPBELL AVE
WEST HAVEN CT
06516-2770
US

V. Phone/Fax

Practice location:
  • Phone: 203-479-8023
  • Fax: 203-479-8001
Mailing address:
  • Phone: 203-479-8023
  • Fax: 203-479-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberE47648
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: