Provider Demographics
NPI:1669496865
Name:MCINERNEY, VINCENT K (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:K
Last Name:MCINERNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:504 VALLEY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3534
Mailing Address - Country:US
Mailing Address - Phone:973-694-2690
Mailing Address - Fax:973-694-2692
Practice Address - Street 1:504 VALLEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3534
Practice Address - Country:US
Practice Address - Phone:973-694-2690
Practice Address - Fax:973-694-2692
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03686600207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC52645Medicare UPIN