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General NPI Number Information
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NPI Number | 1588743835
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Entity Type | Individual
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Provider Name | TARA MICHELE MCNAMARA PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 435 W 57TH ST APT 18C
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City | NEW YORK
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State | NY
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Zip | 10019-1750
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Country | US
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Telephone | 212-397-8028
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Fax | 212-332-9676
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Provider Business Mailing Address
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Address Line | 435 W 57TH ST APT 18C
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City | NEW YORK
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State | NY
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Zip | 10019-1750
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Country | US
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Telephone | 212-397-8028
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Fax | 212-332-9676
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 015561-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 15298
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT0009423L
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License Number State | PA
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