Healthcare Provider Details

I. General information

NPI: 1104734953
Provider Name (Legal Business Name): DAVID ANDREW MCNAUGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 MILLBURN AVE
MAPLEWOOD NJ
07040-3726
US

IV. Provider business mailing address

454 GREENBROOK RD
NORTH PLAINFIELD NJ
07063-1706
US

V. Phone/Fax

Practice location:
  • Phone: 862-800-6080
  • Fax:
Mailing address:
  • Phone: 908-217-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02443500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: