=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740446301
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS JUDE MCQUAID DNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2008
-----------------------------------------------------
Last Update Date | 07/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 286A BRADFORD ST UNIT 9
-----------------------------------------------------
City | PROVINCETOWN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02657-1843
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-566-3554
-----------------------------------------------------
Fax | 203-274-6713
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 286A BRADFORD ST UNIT 9
-----------------------------------------------------
City | PROVINCETOWN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02657-1843
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-566-3554
-----------------------------------------------------
Fax | 203-274-6713
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F334662-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 049930-23
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 003827
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN250520
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------