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General NPI Number Information
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NPI Number | 1629732441
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Entity Type | Individual
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Provider Name | KRISTEN MCNAMARA AGNP
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Gender | Female
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Dates
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Enumeration Date | 10/27/2021
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 535 E 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-4823
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Country | US
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Telephone | 212-774-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 19 BIRCH LN
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City | HOLMES
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State | NY
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Zip | 12531-5302
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Country | US
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Telephone | 845-380-0481
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 309618
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License Number State | NY
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