Provider Demographics
NPI:1508924838
Name:MCGARRY, NADEZHDA
Entity Type:Individual
Prefix:
First Name:NADEZHDA
Middle Name:
Last Name:MCGARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 FORDEM AVE
Mailing Address - Street 2:APT 207
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-4672
Mailing Address - Country:US
Mailing Address - Phone:608-332-5959
Mailing Address - Fax:
Practice Address - Street 1:202 S PARK ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1507
Practice Address - Country:US
Practice Address - Phone:608-267-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1317-019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist