Provider Demographics
NPI:1316404122
Name:MCGARRY, JOSEPH LEO
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEO
Last Name:MCGARRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08848-1929
Mailing Address - Country:US
Mailing Address - Phone:570-885-8296
Mailing Address - Fax:
Practice Address - Street 1:32 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:08848-1929
Practice Address - Country:US
Practice Address - Phone:570-885-8296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00739300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist