MEDICARE: MRS. MARY JOAN DORAN-BARR MSN, RN, APN

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	363LA2100X	Acute Care Nurse Practitioner	26NN04484700	NJ
2	363LA2200X	Adult Health Nurse Practitioner	26NN04484700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972562684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY JOAN DORAN-BARR MSN, RN, APN

Provider Business Mailing Address
First Line	:	9 DUTCHTOWN HARLINGEN RD
Second Line	:	MONTGOMERY MEDICAL ASSOC, LLC
City	:	BELLE MEAD
State	:	NJ
Zip	:	08502-5115
Country	:	US
Telephone Number	:	908-874-8883
Fax Number	:	908-874-5108

Provider Business Practice Location Address
First Line	:	9 DUTCHTOWN HARLINGEN RD
Second Line	:	MONTGOMERY MEDICAL ASSOC, LLC
City	:	BELLE MEAD
State	:	NJ
Zip	:	08502-5115
Country	:	US
Telephone Number	:	908-874-8883
Fax Number	:	908-874-5108

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	09/06/2007

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