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General NPI Number Information
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NPI Number | 1871776856
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Entity Type | Organization
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Legal Business Name | PEDIATRIC HEMATOLOGY-ONCOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 405 CHURCH ST
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City | GUILFORD
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State | CT
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Zip | 06437-2003
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Country | US
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Telephone | 203-453-2013
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Fax | 203-453-6404
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Provider Business Mailing Address
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Address Line | 405 CHURCH ST
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City | GUILFORD
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State | CT
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Zip | 06437-2003
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Country | US
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Telephone | 203-453-2013
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Fax | 203-453-6404
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JOSEPH M MCNAMARA
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Credential | M.D.
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Telephone | 203-453-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 030135
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License Number State | CT
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