Healthcare Provider Details

I. General information

NPI: 1790697282
Provider Name (Legal Business Name): DAVID ANTHONY MACNOW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 SOUTH ST
FREEHOLD NJ
07728-2164
US

IV. Provider business mailing address

4 EXETER DR
MARLBORO NJ
07746-2729
US

V. Phone/Fax

Practice location:
  • Phone: 908-908-9890
  • Fax:
Mailing address:
  • Phone: 732-239-9245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC01002100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: