MEDICARE: JOANNE M MCNAMARA PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	35SI00424300	NJ

General Provider Information

NPI Number	:	1295940401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE M MCNAMARA PH.D.

Provider Business Mailing Address
First Line	:	1648 BAY AVE
Second Line	:	SUITE 2
City	:	PT. PLEASANT BEACH
State	:	NJ
Zip	:	08742
Country	:	US
Telephone Number	:	732-899-8288
Fax Number	:

Provider Business Practice Location Address
First Line	:	1648 BAY AVE
Second Line	:	SUITE 2
City	:	PT. PLEASANT BEACH
State	:	NJ
Zip	:	08742
Country	:	US
Telephone Number	:	732-899-8288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	07/08/2007

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