Healthcare Provider Details

I. General information

NPI: 1114612215
Provider Name (Legal Business Name): ALLEN MCNAMARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALLEN MC NAMARA

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BEECH ST
HOLYOKE MA
01040-2223
US

IV. Provider business mailing address

54 NOLL ST APT 414
BROOKLYN NY
11206-4780
US

V. Phone/Fax

Practice location:
  • Phone: 413-540-5098
  • Fax:
Mailing address:
  • Phone: 910-916-7086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1028695
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: