Provider Demographics
NPI:1083998330
Name:MCNAMARA, LISA E (RN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:E
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:18 LORIJEAN LN
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4011
Mailing Address - Country:US
Mailing Address - Phone:631-266-5420
Mailing Address - Fax:631-266-5495
Practice Address - Street 1:478 ELWOOD RD
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4828
Practice Address - Country:US
Practice Address - Phone:631-266-5420
Practice Address - Fax:631-266-5495
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY4953411163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool