Healthcare Provider Details

I. General information

NPI: 1750141438
Provider Name (Legal Business Name): PATRICK MCNAMARA APN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PATRICK MCNAMARA APN

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 COMMERCE DR STE 305-05
CRANFORD NJ
07016-3505
US

IV. Provider business mailing address

14 COMMERCE DR STE 305-05
CRANFORD NJ
07016-3505
US

V. Phone/Fax

Practice location:
  • Phone: 973-756-3266
  • Fax: 973-425-5661
Mailing address:
  • Phone: 973-756-3266
  • Fax: 973-425-5661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15037500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: