MEDICARE: DR. MADELYN MCNAMARA DPT

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	225100000X	Physical Therapist	053051	NY

General Provider Information

NPI Number	:	1356161236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADELYN MCNAMARA DPT

Provider Business Mailing Address
First Line	:	70 HUNTERS RIDGE RD APT 2
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-1311
Country	:	US
Telephone Number	:	716-352-1544
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 HUNTERS RIDGE RD APT 2
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-1311
Country	:	US
Telephone Number	:	716-352-1544
Fax Number	:

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

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	10/15/2024

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